SUHARDJA, AGUSTINUS
NPI: 1235349473
· GLENDORA, CA 91740
· Diagnostic Radiology Physician
· NPI assigned 05/23/2007
$649.92
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
17 |
$63.32 |
| 2022 |
69 |
$586.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71045 |
Radiologic examination, chest; single view |
68 |
66 |
$512.29 |
| 73564 |
|
18 |
15 |
$137.63 |