CAVALIER COUNTY HEALTH DISTRICT
NPI: 1174566335
· LANGDON, ND 58249
· Public Health or Welfare Agency
· NPI assigned 06/14/2006
Provider Details
| Authorized Official | GUSTAFSON, TERRI (ADMINISTRATOR) |
| NPI Enumeration Date | 06/14/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
152 |
$5K |
| 2019 |
136 |
$3K |
| 2020 |
160 |
$4K |
| 2021 |
237 |
$6K |
| 2022 |
145 |
$2K |
| 2023 |
73 |
$736.14 |
| 2024 |
34 |
$396.10 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
83 |
83 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
391 |
381 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
25 |
$927.36 |
| 90686 |
|
288 |
282 |
$911.58 |
| 0064A |
|
13 |
13 |
$761.26 |
| 92567 |
|
26 |
26 |
$405.24 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$129.74 |
| 90656 |
|
14 |
14 |
$44.70 |
| 91301 |
|
27 |
26 |
$0.00 |
| 99174 |
|
14 |
14 |
$0.00 |
| 91306 |
|
13 |
13 |
$0.00 |