NPI: 1699301671 · DOVE CREEK, CO 81324 · Federally Qualified Health Center (FQHC) · NPI assigned 03/21/2020
Authorized official BURKE, SHELLY controls 18+ related entities in our dataset. Read more
| Authorized Official | BURKE, SHELLY (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | SOUTHWEST MENTAL HEALTH CENTER |
| NPI Enumeration Date | 03/21/2020 |
Other providers sharing the same authorized official: BURKE, SHELLY
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,578 | $302K |
| 2021 | 2,176 | $383K |
| 2022 | 1,965 | $386K |
| 2023 | 1,726 | $318K |
| 2024 | 315 | $61K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 2,828 | 2,325 | $1.01M |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1,547 | 1,376 | $309K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 596 | 549 | $113K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 18 | 16 | $3K |
| 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 | 202 | 180 | $3K |
| D0140 | Limited oral evaluation - problem focused | 322 | 298 | $2K |
| D0274 | Bitewings - four radiographic images | 349 | 338 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 249 | 217 | $1K |
| D0120 | Periodic oral evaluation - established patient | 555 | 547 | $1K |
| D1110 | Prophylaxis - adult | 562 | 557 | $916.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 80 | 77 | $492.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 36 | 29 | $452.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 65 | 50 | $392.00 |
| H0049 | Alcohol and/or drug screening | 133 | 132 | $299.56 |
| D0330 | Panoramic radiographic image | 110 | 109 | $130.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 66 | 66 | $0.00 |
| 96127 | 42 | 41 | $0.00 |