NPI: 1871574210 · EDINA, MO 63537 · Public Health or Welfare Agency · NPI assigned 11/11/2005
| Authorized Official | MOOTS-CLAIR, LORI (ADMINISTRATOR) |
| NPI Enumeration Date | 11/11/2005 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $201.36 |
| 2019 | 13 | $218.14 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 25 | 25 | $419.50 |