GREAT BASIN URGENT CARE LLC
NPI: 1366022444
· LOGAN, UT 84322
· 207Q00000X
$292.90
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
31 |
$292.90 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
|
18 |
12 |
$292.90 |
| 99203 |
|
13 |
12 |
$0.00 |