MAPLE STREET CLINIC, PC
NPI: 1225066194
· FOREST GROVE, OR 97116
· Family Medicine Physician
· NPI assigned 06/29/2006
Provider Details
| Authorized Official | DAHLQUIST, JOHN (CLINIC ADMINISTRATOR) |
| NPI Enumeration Date | 06/29/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,481 |
$65K |
| 2019 |
148 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,324 |
1,096 |
$66K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
44 |
$4K |
| 90686 |
|
71 |
69 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
41 |
$892.81 |
| 81002 |
|
29 |
29 |
$86.80 |
| 1159F |
|
53 |
52 |
$0.45 |
| 99173 |
|
17 |
17 |
$0.00 |
| 3008F |
|
42 |
42 |
$0.00 |