96TH STREET JUNCTION BLVD MEDICAL PC
NPI: 1588157788
· CORONA, NY 11368
· Family Medicine Physician
· NPI assigned 06/12/2018
$224.72
Total Medicaid Paid
Provider Details
| Authorized Official | RUCKER, WILDER (OWNER) |
| NPI Enumeration Date | 06/12/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
81 |
$224.72 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
65 |
$224.72 |