QUINAULT INDIAN NATION
NPI: 1457542847
· TAHOLAH, WA 98587
· Dental Clinic/Center
· NPI assigned 08/09/2007
$1.38M
Total Medicaid Paid
Provider Details
| Authorized Official | RALSTON, MARIAH (BILLING MANAGER) |
| NPI Enumeration Date | 08/09/2007 |
Related Entities
Other providers sharing the same authorized official: RALSTON, MARIAH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,555 |
$266K |
| 2019 |
1,059 |
$200K |
| 2020 |
452 |
$108K |
| 2021 |
1,081 |
$279K |
| 2022 |
796 |
$141K |
| 2023 |
964 |
$208K |
| 2024 |
1,015 |
$183K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,205 |
3,070 |
$1.34M |
| D0140 |
Limited oral evaluation - problem focused |
1,398 |
1,110 |
$25K |
| D1206 |
Topical application of fluoride varnish |
368 |
344 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
192 |
160 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
229 |
206 |
$4K |
| D1110 |
Prophylaxis - adult |
119 |
119 |
$3K |
| D0330 |
Panoramic radiographic image |
70 |
41 |
$915.17 |
| D0220 |
Intraoral - periapical first radiographic image |
177 |
98 |
$861.78 |
| D1120 |
Prophylaxis - child |
16 |
16 |
$367.68 |
| D0191 |
|
17 |
16 |
$0.00 |
| D1330 |
|
30 |
27 |
$0.00 |
| D9215 |
|
101 |
60 |
$0.00 |