DOLORES COUNTY HEALTH ASSOCIATION
NPI: 1568937639
· CORTEZ, CO 81321
· Dentist
· NPI assigned 10/04/2018
$269K
Total Medicaid Paid
Provider Details
| Authorized Official | PEHRSON, LINCOLN (EXECUTIVE DIRECTOR) |
| Parent Organization | DOLORES COUNTY HEALTH ASSOCIATION |
| NPI Enumeration Date | 10/04/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
878 |
$198K |
| 2020 |
303 |
$72K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
903 |
656 |
$267K |
| D0140 |
Limited oral evaluation - problem focused |
110 |
95 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
96 |
86 |
$432.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
72 |
69 |
$258.00 |