Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

BRAZOSPORT PEDIATRIC CLINIC, P.A.

NPI: 1407860737 · LAKE JACKSON, TX 77566 · Pediatrics Physician · NPI assigned 07/29/2006

$190.38
Total Medicaid Paid
22
Total Claims
16
Beneficiaries
1
Codes Billed
2019-10
First Month
2019-10
Last Month

Provider Details

Authorized OfficialHARDOIN, RICHARD (PRESIDENT)
NPI Enumeration Date07/29/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 22 $190.38

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90460 Immunization administration through 18 years of age via any route, first or only component 22 16 $190.38