NPI: 1760646509 · MERIDIAN, MS 39301 · Student in an Organized Health Care Education/Training Program · NPI assigned 07/10/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $404.40 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 12 | 12 | $404.40 |