NPI: 1104442847 · LAS CRUCES, NM 88005 · Primary Care Clinic/Center · NPI assigned 06/18/2020
| Authorized Official | PORTILLO, DIANA (OWNER/PROVIDER) |
| NPI Enumeration Date | 06/18/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 13 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99215 | Prolong outpt/office vis | 13 | 12 | $2K |