DISTRICT MEDICAL GROUP, INC
NPI: 1407106719
· PHOENIX, AZ 85013
· Clinic/Center
· NPI assigned 09/13/2012
$366K
Total Medicaid Paid
Provider Details
| Authorized Official | CORDEIRO, TERESA (DIRECTOR, CREDENTIALING) |
| Parent Organization | DISTRICT MEDICAL GROUP, INC |
| NPI Enumeration Date | 09/13/2012 |
Related Entities
Other providers sharing the same authorized official: CORDEIRO, TERESA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
310 |
$86K |
| 2019 |
473 |
$119K |
| 2020 |
392 |
$95K |
| 2021 |
53 |
$15K |
| 2022 |
189 |
$51K |
| 2023 |
38 |
$71.56 |
| 2024 |
195 |
$15.03 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,374 |
1,020 |
$362K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
25 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
40 |
39 |
$38.11 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$30.02 |
| D0230 |
Intraoral - periapical each additional radiographic image |
26 |
26 |
$18.46 |
| D1120 |
Prophylaxis - child |
50 |
50 |
$0.00 |
| D1110 |
Prophylaxis - adult |
37 |
37 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
67 |
67 |
$0.00 |