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NORTH CENTRAL DISTRICT HEALTH DEPARTMENT
NORTH CENTRAL DISTRICT HEALTH DEPARTMENT
NPI: 1528302429
· ONEILL, NE 68763
· Public Health or Welfare Agency
· NPI assigned 11/15/2012
$144K
Total Medicaid Paid
Provider Details
| Authorized Official | WIESE, ROGER (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 11/15/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
904 |
$17K |
| 2019 |
915 |
$22K |
| 2020 |
545 |
$14K |
| 2021 |
958 |
$21K |
| 2022 |
768 |
$18K |
| 2023 |
1,026 |
$28K |
| 2024 |
1,238 |
$25K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
5,333 |
5,265 |
$130K |
| D0190 |
|
578 |
571 |
$9K |
| 90686 |
|
106 |
105 |
$1K |
| D1351 |
Sealant - per tooth |
46 |
12 |
$1K |
| 91320 |
|
26 |
24 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
117 |
$701.11 |
| D1110 |
Prophylaxis - adult |
17 |
17 |
$528.00 |
| 90480 |
|
43 |
40 |
$301.93 |
| 91301 |
|
18 |
18 |
$0.00 |
| D4355 |
|
19 |
19 |
$0.00 |
| 91307 |
|
12 |
12 |
$0.00 |
| 0013A |
|
35 |
35 |
$0.00 |