NPI: 1285611129 · MILES CITY, MT 59301 · Federally Qualified Health Center (FQHC) · NPI assigned 12/30/2005
Authorized official MARK, DAVID controls 19+ related entities in our dataset. Read more
| Authorized Official | MARK, DAVID (CEO) |
| NPI Enumeration Date | 12/30/2005 |
Other providers sharing the same authorized official: MARK, DAVID
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,129 | $0.00 |
| 2019 | 2,334 | $0.00 |
| 2020 | 2,239 | $13K |
| 2021 | 2,249 | $5K |
| 2022 | 2,232 | $3K |
| 2023 | 2,120 | $0.00 |
| 2024 | 1,471 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 125 | 120 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 107 | 104 | $3K |
| D1206 | Topical application of fluoride varnish | 150 | 147 | $3K |
| D0274 | Bitewings - four radiographic images | 81 | 79 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 144 | 138 | $2K |
| D1110 | Prophylaxis - adult | 26 | 25 | $1K |
| D7140 | Extraction, erupted tooth or exposed root | 19 | 12 | $942.68 |
| D0140 | Limited oral evaluation - problem focused | 44 | 44 | $490.84 |
| D0120 | Periodic oral evaluation - established patient | 19 | 18 | $441.72 |
| 90832 | Psychotherapy, 30 minutes with patient | 2,225 | 1,365 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1,114 | 916 | $0.00 |
| D1999 | 13 | 13 | $0.00 | |
| 80305 | 319 | 204 | $0.00 | |
| 90837 | Psychotherapy, 53 minutes with patient | 58 | 43 | $0.00 |
| 99442 | 31 | 25 | $0.00 | |
| 98968 | 47 | 29 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 19 | 16 | $0.00 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 12 | 12 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 12 | 12 | $0.00 |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7,010 | 5,495 | $0.00 |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1,181 | 1,055 | $0.00 |
| 90834 | Psychotherapy, 45 minutes with patient | 198 | 121 | $0.00 |
| 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 | 81 | 65 | $0.00 |
| Q3014 | Telehealth originating site facility fee | 541 | 380 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 58 | 52 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 110 | 98 | $0.00 |
| 90686 | 30 | 28 | $0.00 |