SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
NPI: 1639417280
· WILMINGTON, DE 19801
· Dentist
· NPI assigned 01/16/2013
$125K
Total Medicaid Paid
Provider Details
| Authorized Official | RIVERA, ROSA (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC |
| NPI Enumeration Date | 01/16/2013 |
Related Entities
Other providers sharing the same authorized official: RIVERA, ROSA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,668 |
$27K |
| 2019 |
1,568 |
$57K |
| 2020 |
347 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
1,088 |
886 |
$73K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,725 |
1,514 |
$52K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
246 |
196 |
$15.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
524 |
484 |
$0.00 |