CCRC - SOUTH PORT SQUARE, LLC
NPI: 1376957803
· PORT CHARLOTTE, FL 33980
· Skilled Nursing Facility
· NPI assigned 06/12/2014
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | ARCE, NOAH (ADMINISTRATOR) |
| NPI Enumeration Date | 06/12/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
56 |
$0.00 |
| 2021 |
90 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
73 |
46 |
$0.00 |
| 90694 |
|
28 |
18 |
$0.00 |
| 90662 |
|
45 |
28 |
$0.00 |