LAKESIDE WALK-IN CLINIC PLLC
NPI: 1205345154
· HOT SPRINGS, AR 71901
· General Practice Physician
· NPI assigned 09/22/2017
$623.20
Total Medicaid Paid
Provider Details
| Authorized Official | ENNIS, ERNEST (OWNER) |
| NPI Enumeration Date | 09/22/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
16 |
$623.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
14 |
$623.20 |