NPI: 1144705930 · SHREVEPORT, LA 71107 · Federally Qualified Health Center (FQHC) · NPI assigned 09/27/2018
Authorized official WHITE, WILLIE controls 16+ related entities in our dataset. Read more
| Authorized Official | WHITE, WILLIE (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | DAVID RAINES COMMUNITY HEALTH CENTER INC |
| NPI Enumeration Date | 09/27/2018 |
Other providers sharing the same authorized official: WHITE, WILLIE
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 768 | $54K |
| 2024 | 305 | $30K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 928 | 538 | $84K |
| D0220 | Intraoral - periapical first radiographic image | 23 | 15 | $0.00 |
| D1110 | Prophylaxis - adult | 34 | 20 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 16 | 12 | $0.00 |
| D7140 | Extraction, erupted tooth or exposed root | 72 | 26 | $0.00 |