DAGENAIS & ASSOCIATES MEDICAL CLINIC, LLC
NPI: 1043618572
· PAWHUSKA, OK 74056
· Medical Physician Assistant
· NPI assigned 12/16/2014
$297K
Total Medicaid Paid
Provider Details
| Authorized Official | DAGENAIS, MARY (OWNER) |
| NPI Enumeration Date | 12/16/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
628 |
$50K |
| 2019 |
792 |
$62K |
| 2020 |
512 |
$42K |
| 2021 |
629 |
$63K |
| 2022 |
635 |
$61K |
| 2023 |
182 |
$19K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,107 |
2,859 |
$277K |
| 99215 |
Prolong outpt/office vis |
119 |
113 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
70 |
$2K |
| 96160 |
|
82 |
82 |
$0.00 |