PREMIER RURAL FAMILY MEDICAL & DENTAL CARE, LLC
NPI: 1417444043
· CRIPPLE CREEK, CO 80813
· Dentist
· NPI assigned 04/19/2018
$879.47
Total Medicaid Paid
Provider Details
| Authorized Official | ROBERS, WILLIAM (ATTORNEY) |
| NPI Enumeration Date | 04/19/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$879.47 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$879.47 |