NPI: 1437202124 · BANNING, CA 92220 · Federally Qualified Health Center (FQHC) · NPI assigned 01/18/2007
| Authorized Official | THOMSEN, WILLIAM (CEO) |
| NPI Enumeration Date | 01/18/2007 |
Other providers sharing the same authorized official: THOMSEN, WILLIAM
| Provider | City | State | Total Paid |
|---|---|---|---|
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. | GRAND TERRACE | CA | $18.74M |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. | GRAND TERRACE | CA | $4.13M |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. | SAN JACINTO | CA | $3.30M |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC | TEMECULA | CA | $642K |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. | THERMAL | CA | $613K |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC | BARSTOW | CA | $31K |
| RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC | MOUNTAIN CENTER | CA | $19K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,151 | $476K |
| 2019 | 932 | $406K |
| 2020 | 720 | $272K |
| 2021 | 1,083 | $441K |
| 2022 | 1,044 | $567K |
| 2023 | 1,347 | $531K |
| 2024 | 1,619 | $594K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 00003 | Internal/system code - not a standard HCPCS code | 5,806 | 4,664 | $3.20M |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 194 | 179 | $76K |
| T1015 | Clinic visit/encounter, all-inclusive | 24 | 13 | $10K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12 | 12 | $5K |
| D0120 | Periodic oral evaluation - established patient | 463 | 450 | $0.00 |
| D1320 | 56 | 52 | $0.00 | |
| D1330 | 49 | 46 | $0.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 539 | 301 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 574 | 547 | $0.00 |
| D0274 | Bitewings - four radiographic images | 94 | 86 | $0.00 |
| D1110 | Prophylaxis - adult | 38 | 38 | $0.00 |
| D1999 | 29 | 28 | $0.00 | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 18 | 13 | $0.00 |