HILLSIDE MEDICAL OFFICE LLC
NPI: 1912969486
· WICHITA, KS 67214
· Family Medicine Physician
· NPI assigned 04/03/2006
$816.80
Total Medicaid Paid
Provider Details
| Authorized Official | GORDON, DAVID (MANAGER) |
| NPI Enumeration Date | 04/03/2006 |
Related Entities
Other providers sharing the same authorized official: GORDON, DAVID
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
43 |
$816.80 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
25 |
$816.80 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
12 |
$0.00 |