NPI: 1740553734 · CUBA, NM 87013 · Federally Qualified Health Center (FQHC) · NPI assigned 02/22/2012
Authorized official SMITH, DOUG controls 20+ related entities in our dataset. Read more
| Authorized Official | SMITH, DOUG (EXECUTIVE VICE PRESIDENT) |
| NPI Enumeration Date | 02/22/2012 |
Other providers sharing the same authorized official: SMITH, DOUG
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 712 | $99K |
| 2019 | 482 | $63K |
| 2020 | 72 | $13K |
| 2021 | 287 | $33K |
| 2022 | 492 | $66K |
| 2023 | 332 | $53K |
| 2024 | 585 | $89K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 830 | 680 | $148K |
| 90832 | Psychotherapy, 30 minutes with patient | 566 | 312 | $102K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 467 | 404 | $80K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 203 | 195 | $38K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 194 | 179 | $37K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 45 | 43 | $7K |
| 90834 | Psychotherapy, 45 minutes with patient | 19 | 13 | $3K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 56 | 54 | $249.60 |
| D1120 | Prophylaxis - child | 12 | 12 | $0.00 |
| 81002 | 140 | 137 | $0.00 | |
| 99173 | 139 | 137 | $0.00 | |
| D0220 | Intraoral - periapical first radiographic image | 26 | 26 | $0.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 26 | 26 | $0.00 |
| D1206 | Topical application of fluoride varnish | 12 | 12 | $0.00 |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 53 | 48 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 45 | 44 | $0.00 |
| 90656 | 12 | 12 | $0.00 | |
| 92551 | 13 | 12 | $0.00 | |
| 85018 | 19 | 19 | $0.00 | |
| 90686 | 39 | 39 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 15 | 15 | $0.00 |
| 82962 | 19 | 17 | $0.00 | |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $0.00 |