NPI: 1790319408 · NORTH CHARLESTON, SC 29418 · Family Medicine Physician · NPI assigned 03/03/2020
| Authorized Official | JAQUEZ, STEPHANIE (SOLE MBR) |
| NPI Enumeration Date | 03/03/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 120 | $1K |
| 2022 | 34 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 154 | 55 | $3K |