NPI: 1316282072 · JACKSON, WY 83001 · Family Medicine Physician · NPI assigned 12/06/2012
| Authorized Official | SAXTON, JAMMIE (ACCOUNT MANAGER) |
| NPI Enumeration Date | 12/06/2012 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 14 | $745.74 |
| 2022 | 12 | $450.56 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 26 | 26 | $1K |