WAGNER, CAROLYN
NPI: 1801142302
· LAKE JACKSON, TX 77566
· Pediatrics Physician
· NPI assigned 08/02/2012
$255.75
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
42 |
$0.00 |
| 2021 |
146 |
$0.00 |
| 2022 |
196 |
$255.75 |
| 2023 |
70 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
12 |
$255.75 |
| 1031F |
|
429 |
413 |
$0.00 |