AUNT MARTHA'S YOUTH SERVICE CENTER
NPI: 1982150983
· EAST DUNDEE, IL 60118
· Federally Qualified Health Center (FQHC)
· NPI assigned 08/30/2016
$825.75
Total Medicaid Paid
Provider Details
| Authorized Official | PENNINGTON, AUDREY (EXECUTIVE VP OF HEALTH) |
| NPI Enumeration Date | 08/30/2016 |
Related Entities
Other providers sharing the same authorized official: PENNINGTON, AUDREY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
15 |
$825.75 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
15 |
13 |
$825.75 |