NPI: 1205477841 · SAN DIEGO, CA 92115 · Federally Qualified Health Center (FQHC) · NPI assigned 10/04/2019
Authorized official MATTSON, KEVIN controls 16+ related entities in our dataset. Read more
| Authorized Official | MATTSON, KEVIN (PRESIDENT/CEO) |
| NPI Enumeration Date | 10/04/2019 |
Other providers sharing the same authorized official: MATTSON, KEVIN
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 16 | $114.88 |
| 2022 | 462 | $13K |
| 2023 | 123 | $4K |
| 2024 | 185 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 304 | 286 | $10K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 245 | 227 | $4K |
| D4341 | 28 | 14 | $4K | |
| D9430 | 101 | 83 | $2K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 13 | $624.00 |
| 97026 | 16 | 14 | $114.88 | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 51 | 47 | $74.26 |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 28 | 28 | $0.00 |