NPI: 1366717860 · BULLHEAD CITY, AZ 86442 · Compounding Pharmacy · NPI assigned 03/15/2012
| Authorized Official | KESITILWE, EZEKIEL (OWNER) |
| NPI Enumeration Date | 03/15/2012 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 16 | $760.98 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16 | 15 | $760.98 |