360 WELLNESS CLINIC LLC
NPI: 1366048803
· BENTON, AR 72015
· Rural Health Clinic/Center
· NPI assigned 12/09/2020
$26.28
Total Medicaid Paid
Provider Details
| Authorized Official | TORRES, BLAKE (OWNER) |
| NPI Enumeration Date | 12/09/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
45 |
$26.28 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
34 |
$26.28 |