CLINIC AT WELLSTON
NPI: 1528589546
· WELLSTON, OK 74881
· Family Medicine Physician
· NPI assigned 06/29/2017
$166K
Total Medicaid Paid
3,166
Beneficiary Records
Provider Details
| Authorized Official | GROFF, SISNE (OWNER/OPERATOR) |
| NPI Enumeration Date | 06/29/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,139 |
$55K |
| 2019 |
2,355 |
$110K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,750 |
1,559 |
$126K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
462 |
442 |
$25K |
| 80305 |
|
1,269 |
1,153 |
$14K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$2K |