ARIZONA SKIN AND LASER THERAPY INSTITUTE, LTD

NPI: 1770519019 · PHOENIX, AZ 85032 · Dermatology Physician · NPI assigned 06/25/2006

$14K

Total Medicaid Paid

369

Total Claims

347

Beneficiaries

Codes Billed

2018-01

First Month

2019-09

Last Month

Provider Details

Authorized Official	SUPERFON, NEIL (OWNER/PHYSICIAN)
NPI Enumeration Date	06/25/2006

Other providers sharing the same authorized official: SUPERFON, NEIL

Provider	City	State	Total Paid
ARIZONA MOBILE DERMATOLOGY AND WOUND CARE PLC	SCOTTSDALE	AZ	$55K
ARIZONA SKIN AND LASER THERAPY INSTITUTE, LTD	GILBERT	AZ	$14K
ARIZONA SKIN AND LASER THERAPY INSTITUTE, LTD	SHOW LOW	AZ	$1K

Year	Claims	Total Paid
2018	320	$12K
2019	49	$2K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	291	270	$11K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	21	21	$914.40
11100		15	15	$901.49
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	19	18	$865.66
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	23	23	$705.10