LCH HEALTH AND COMMUNITY SERVICES

NPI: 1447709571 · WEST GROVE, PA 19390 · Federally Qualified Health Center (FQHC) · NPI assigned 09/30/2016

$65K

Total Medicaid Paid

1,004

Total Claims

911

Beneficiaries

Codes Billed

2020-11

First Month

2021-11

Last Month

Provider Details

Authorized Official	CAULFIELD, MELODY (COMPLIANCE & ACCREDITATION ADMIN)
NPI Enumeration Date	09/30/2016

Other providers sharing the same authorized official: CAULFIELD, MELODY

Provider	City	State	Total Paid
LCH HEALTH AND COMMUNITY SERVICES	WEST GROVE	PA	$977K
LCH HEALTH AND COMMUNITY SERVICES	OXFORD	PA	$723K

Year	Claims	Total Paid
2020	106	$7K
2021	898	$58K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	544	471	$65K
D0150	Comprehensive oral evaluation - new or established patient	73	73	$0.00
D0230	Intraoral - periapical each additional radiographic image	46	39	$0.00
D0120	Periodic oral evaluation - established patient	97	97	$0.00
D0210	Intraoral - complete series of radiographic images	26	26	$0.00
D0220	Intraoral - periapical first radiographic image	116	103	$0.00
D1110	Prophylaxis - adult	76	76	$0.00
D0274	Bitewings - four radiographic images	26	26	$0.00