NPI: 1871911016 · FORT WORTH, TX 76177 · 261QA1903X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 599 | $60K |
| 2021 | 11,632 | $947K |
| 2022 | 29,013 | $2.29M |
| 2023 | 36,904 | $3.29M |
| 2024 | 21,743 | $1.62M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | 33,827 | 32,646 | $4.33M | |
| 99284 | 7,148 | 6,630 | $2.42M | |
| 87804 | 12,749 | 9,685 | $305K | |
| 99282 | 2,306 | 2,228 | $300K | |
| 87426 | 3,006 | 2,917 | $186K | |
| U0003 | Cov-19 amp prb hgh thruput | 4,044 | 3,876 | $166K |
| 71045 | 3,888 | 3,682 | $95K | |
| 87880 | 3,388 | 3,262 | $67K | |
| 87430 | 2,453 | 2,378 | $49K | |
| 96374 | 1,135 | 1,053 | $47K | |
| 80053 | 3,868 | 3,539 | $46K | |
| 87635 | 661 | 617 | $39K | |
| 87070 | 3,107 | 3,021 | $39K | |
| 85027 | 5,997 | 5,395 | $27K | |
| 93005 | 757 | 691 | $20K | |
| J7030 | Normal saline solution infus | 1,437 | 1,305 | $12K |
| 81001 | 3,423 | 3,215 | $10K | |
| 76801 | 61 | 52 | $6K | |
| 81025 | 762 | 718 | $6K | |
| 71046 | 100 | 99 | $5K | |
| 84484 | 574 | 432 | $5K | |
| 99281 | 41 | 40 | $4K | |
| 83690 | 1,067 | 989 | $3K | |
| J1100 | Dexamethasone sodium phos | 768 | 593 | $3K |
| 36415 | 1,221 | 1,089 | $2K | |
| 99285 | 12 | 12 | $2K | |
| 87420 | 131 | 124 | $2K | |
| 74177 | 18 | 15 | $2K | |
| 84702 | 135 | 113 | $2K | |
| J2405 | Ondansetron hcl injection | 307 | 261 | $2K |
| 76817 | 15 | 12 | $1K | |
| 87807 | 58 | 50 | $920.55 | |
| Q9967 | Locm 300-399mg/ml iodine,1ml | 115 | 90 | $777.32 |
| J1885 | Ketorolac tromethamine inj | 613 | 355 | $720.00 |
| 81003 | 116 | 107 | $710.10 | |
| 70450 | 13 | 13 | $652.21 | |
| 80048 | 92 | 84 | $565.01 | |
| 87086 | 26 | 26 | $294.92 | |
| 83880 | 45 | 38 | $201.95 | |
| 86901 | 76 | 70 | $150.60 | |
| 85610 | 116 | 107 | $98.02 | |
| 96375 | 59 | 51 | $9.39 | |
| J2270 | Morphine sulfate injection | 26 | 12 | $8.72 |
| G1003 | Cdsm medicalis | 14 | 12 | $0.00 |
| A9270 | Non-covered item or service | 32 | 28 | $0.00 |
| 96372 | 84 | 80 | $0.00 |