GRAVE DE PERALTA, JOSE
NPI: 1033186838
· THOMASVILLE, GA 31792
· Pediatrics Physician
· NPI assigned 03/01/2006
$982.02
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$482.46 |
| 2020 |
19 |
$499.56 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19 |
12 |
$499.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$482.46 |