GREAT BASIN URGENT CARE LLC
NPI: 1366022444
· LOGAN, UT 84322
· Family Medicine Physician
· NPI assigned 04/12/2021
$292.90
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
31 |
$292.90 |
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 |
18 |
12 |
$292.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$0.00 |