COLUMBIA BASIN HEALTH ASSOCIATION

NPI: 1679251318 · ROYAL CITY, WA 99357 · Dental Clinic/Center · NPI assigned 07/11/2023

$275K

Total Medicaid Paid

3,131

Total Claims

2,930

Beneficiaries

Codes Billed

2023-10

First Month

2024-12

Last Month

Provider Details

Authorized Official	BUNCH, JOSHUA (CFO)
Parent Organization	COLUMBIA BASIN HEALTH ASSOCIATION
NPI Enumeration Date	07/11/2023

Other providers sharing the same authorized official: BUNCH, JOSHUA

Provider	City	State	Total Paid
COLUMBIA BASIN HEALTH ASSOCIATION	OTHELLO	WA	$27.50M
COLUMBIA BASIN HEALTH ASSOCIATION	OTHELLO	WA	$9.26M
COLUMBIA BASIN HEALTH ASSOCIATION	CONNELL	WA	$5.66M
COLUMBIA BASIN HEALTH ASSOCIATION	MATTAWA	WA	$2.74M
COLUMBIA BASIN HEALTH ASSOCIATION	PASCO	WA	$10K
COLUMBIA BASIN HEALTH ASSOCIATION	MATTAWA	WA	$48.26

Year	Claims	Total Paid
2023	825	$59K
2024	2,306	$216K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	1,034	940	$212K
D0120	Periodic oral evaluation - established patient	532	528	$18K
D1206	Topical application of fluoride varnish	490	487	$13K
D2391	Resin-based composite - one surface, posterior, primary or permanent	148	87	$10K
D1120	Prophylaxis - child	300	300	$9K
D1110	Prophylaxis - adult	127	126	$6K
D0274	Bitewings - four radiographic images	162	158	$2K
D1351	Sealant - per tooth	59	26	$2K
D0272	Bitewings - two radiographic images	120	119	$1K
D0150	Comprehensive oral evaluation - new or established patient	14	14	$692.95
D1330		145	145	$0.00