NPI: 1568219483 · GRAND JUNCTION, CO 81501 · Federally Qualified Health Center (FQHC) · NPI assigned 04/30/2024
| Authorized Official | RAMACHANDRAN, LATA (CEO) |
| NPI Enumeration Date | 04/30/2024 |
Other providers sharing the same authorized official: RAMACHANDRAN, LATA
| Provider | City | State | Total Paid |
|---|---|---|---|
| MARILLAC CLINIC, INC. | GRAND JUNCTION | CO | $38.29M |
| MARILLAC CLINIC, INC | GRAND JUNCTION | CO | $1.57M |
| MARILLAC CLINIC, INC. | MONTROSE | CO | $734K |
| MARILLAC CLINIC, INC. | GRAND JUNCTION | CO | $222K |
| MARILLAC CLINIC, INC | GRAND JUNCTION | CO | $198K |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 23 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 23 | 20 | $9K |