SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
NPI: 1518588896
· SAINT JAMES, MO 65559
· Federally Qualified Health Center (FQHC)
· NPI assigned 04/28/2020
Provider Details
| Authorized Official | GIPSON, STUART (CEO) |
| Parent Organization | SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER |
| NPI Enumeration Date | 04/28/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
109 |
$7K |
| 2021 |
45 |
$4K |
| 2024 |
54 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
92 |
89 |
$9K |
| D0272 |
Bitewings - two radiographic images |
43 |
42 |
$2K |
| D0330 |
Panoramic radiographic image |
15 |
14 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
26 |
26 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
18 |
13 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
13 |
$406.64 |