NPI: 1962953810 · WASILLA, AK 99654 · Primary Care Clinic/Center · NPI assigned 10/16/2016
| Authorized Official | PETERSEN, LYDIA (OWNER) |
| NPI Enumeration Date | 10/16/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 14 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 14 | 12 | $1K |