NPI: 1629020177 · IDABEL, OK 74745 · 174400000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12,180 | $564K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | 1,829 | 1,799 | $230K | |
| 99284 | 519 | 511 | $93K | |
| 99285 | 270 | 267 | $53K | |
| 99282 | 545 | 538 | $39K | |
| 96372 | 596 | 534 | $21K | |
| 96365 | 208 | 207 | $17K | |
| 96374 | 173 | 170 | $15K | |
| 87804 | 644 | 632 | $14K | |
| 74178 | 78 | 78 | $13K | |
| 80053 | 1,010 | 987 | $11K | |
| 70450 | 193 | 193 | $8K | |
| 71046 | 573 | 565 | $8K | |
| 85025 | 965 | 938 | $7K | |
| 87430 | 542 | 537 | $7K | |
| 96375 | 184 | 152 | $3K | |
| 86756 | 198 | 196 | $3K | |
| 36415 | 1,079 | 1,001 | $2K | |
| 81001 | 761 | 710 | $2K | |
| 71045 | 300 | 291 | $2K | |
| 80305 | 173 | 140 | $2K | |
| 93005 | 177 | 173 | $1K | |
| 86710 | 41 | 41 | $1K | |
| 84703 | 143 | 141 | $1K | |
| G0379 | Direct refer hospital observ | 19 | 15 | $970.72 |
| 72125 | 13 | 13 | $968.04 | |
| G0463 | Hospital outpt clinic visit | 23 | 16 | $874.86 |
| 82550 | 103 | 93 | $868.25 | |
| 94640 | 45 | 45 | $698.74 | |
| 83690 | 95 | 95 | $638.64 | |
| 74022 | 29 | 28 | $614.04 | |
| 82553 | 26 | 24 | $492.66 | |
| 84443 | 25 | 25 | $426.75 | |
| 85610 | 105 | 105 | $421.81 | |
| 96361 | 15 | 13 | $320.43 | |
| Q9967 | Locm 300-399mg/ml iodine,1ml | 78 | 78 | $293.40 |
| 84484 | 13 | 12 | $194.94 | |
| 82150 | 30 | 30 | $163.18 | |
| 99239 | 12 | 12 | $112.84 | |
| J1885 | Ketorolac tromethamine inj | 218 | 213 | $12.93 |
| J0696 | Ceftriaxone sodium injection | 116 | 115 | $0.00 |
| J2300 | Inj nalbuphine hydrochloride | 14 | 14 | $0.00 |