NPI: 1881695948 · BROKEN BOW, OK 74728 · 363A00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 853 | $47K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | 407 | 354 | $35K | |
| 99203 | 36 | 36 | $3K | |
| 96372 | 103 | 98 | $3K | |
| 87804 | 103 | 102 | $3K | |
| 99407 | 59 | 58 | $1K | |
| J3301 | Triamcinolone acet inj nos | 46 | 46 | $670.70 |
| 87880 | 33 | 31 | $448.80 | |
| 94640 | 12 | 12 | $171.12 | |
| 87807 | 13 | 13 | $158.21 | |
| J0696 | Ceftriaxone sodium injection | 16 | 16 | $38.43 |
| 36415 | 13 | 13 | $32.11 | |
| J7613 | Albuterol non-comp unit | 12 | 12 | $0.60 |