NPI: 1134755119 · CORTEZ, CO 81321 · Federally Qualified Health Center (FQHC) · NPI assigned 03/21/2020
Authorized official BURKE, SHELLY controls 18+ related entities in our dataset. Read more
| Authorized Official | BURKE, SHELLY (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC |
| NPI Enumeration Date | 03/21/2020 |
Other providers sharing the same authorized official: BURKE, SHELLY
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 259 | $87K |
| 2022 | 1,288 | $301K |
| 2023 | 983 | $208K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 1,666 | 1,494 | $596K |
| D0220 | Intraoral - periapical first radiographic image | 99 | 99 | $0.00 |
| D1110 | Prophylaxis - adult | 217 | 217 | $0.00 |
| D0274 | Bitewings - four radiographic images | 32 | 32 | $0.00 |
| D0330 | Panoramic radiographic image | 24 | 24 | $0.00 |
| D0140 | Limited oral evaluation - problem focused | 149 | 147 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 190 | 190 | $0.00 |
| D0210 | Intraoral - complete series of radiographic images | 15 | 15 | $0.00 |
| D0120 | Periodic oral evaluation - established patient | 94 | 94 | $0.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 32 | 26 | $0.00 |
| D4346 | 12 | 12 | $0.00 |