STATE OF MAINE
NPI: 1053319566
· AUGUSTA, ME 04333
· Psychiatric Hospital
· NPI assigned 07/08/2005
Provider Details
| Authorized Official | GAGNON, JENNIFER (FINANCIAL MANAGER) |
| NPI Enumeration Date | 07/08/2005 |
Related Entities
Other providers sharing the same authorized official: GAGNON, JENNIFER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
530 |
$7K |
| 2019 |
1,414 |
$15K |
| 2020 |
313 |
$3K |
| 2021 |
37 |
$220.00 |
| 2022 |
342 |
$8K |
| 2023 |
578 |
$19K |
| 2024 |
544 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,087 |
2,080 |
$44K |
| D0274 |
Bitewings - four radiographic images |
653 |
652 |
$12K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
161 |
120 |
$10K |
| D0330 |
Panoramic radiographic image |
87 |
84 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
454 |
453 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
193 |
179 |
$2K |
| D2330 |
|
16 |
13 |
$748.00 |
| D0220 |
Intraoral - periapical first radiographic image |
95 |
95 |
$718.50 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$182.00 |