MANTACHIE RURAL HEALTH CARE, INC. DENTAL
NPI: 1063779130
· MANTACHIE, MS 38855
· Federally Qualified Health Center (FQHC)
· NPI assigned 04/13/2012
$321.90
Total Medicaid Paid
Provider Details
| Authorized Official | BURNS, KAREN (COO) |
| NPI Enumeration Date | 04/13/2012 |
Related Entities
Other providers sharing the same authorized official: BURNS, KAREN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
150 |
$321.90 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
62 |
44 |
$321.90 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
88 |
88 |
$0.00 |