NPI: 1366512444 · KINGMAN, AZ 86409 · Non-Pharmacy Dispensing Site · NPI assigned 11/08/2006
| Authorized Official | SHACKELFORD, DIRENDIA (MANAGED CARE SPECIALIST) |
| NPI Enumeration Date | 11/08/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 196 | $8K |
| 2019 | 27 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 223 | 217 | $9K |