BOLD CITY DERMATOLOGY LLC
NPI: 1538761655
· ST AUGUSTINE, FL 32095
· Dermatology Physician
· NPI assigned 11/13/2020
$0.00
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: AL DABAGH, BISHR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
304 |
$0.00 |
| 2023 |
48 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 17110 |
|
27 |
14 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
311 |
122 |
$0.00 |