JACKSON PEDIATRIC ASSOCIATES, LLC
NPI: 1912335530
· JACKSON, WY 83001
· Primary Care Clinic/Center
· NPI assigned 10/16/2013
Provider Details
| Authorized Official | RIDDELL, TRAVIS (PEDIATRICIAN) |
| NPI Enumeration Date | 10/16/2013 |
Related Entities
Other providers sharing the same authorized official: RIDDELL, TRAVIS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
288 |
$8K |
| 2019 |
60 |
$3K |
| 2020 |
167 |
$2K |
| 2021 |
63 |
$733.12 |
| 2023 |
70 |
$835.51 |
| 2024 |
60 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
73 |
63 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
492 |
462 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
26 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
37 |
$597.07 |
| 90686 |
|
14 |
13 |
$22.39 |
| 90688 |
|
24 |
24 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |