SOUTHEAST MISSOURI HEALTH NETWORK
NPI: 1720209794
· MALDEN, MO 63863
· Federally Qualified Health Center (FQHC)
· NPI assigned 05/01/2007
Provider Details
| Authorized Official | WHITE, CHERYL (CEO) |
| Parent Organization | SOUTHEAST MISSOURI HEALTH NETWORK |
| NPI Enumeration Date | 05/01/2007 |
Related Entities
Other providers sharing the same authorized official: WHITE, CHERYL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$515.20 |
| 2019 |
73 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
50 |
50 |
$3K |
| D1206 |
Topical application of fluoride varnish |
35 |
35 |
$1K |