BEN ARCHER HEALTH CENTER
NPI: 1831352533
· HATCH, NM 87937
· Federally Qualified Health Center (FQHC)
· NPI assigned 07/03/2008
$1.57M
Total Medicaid Paid
Provider Details
| Authorized Official | GARAY, MARY (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 07/03/2008 |
Related Entities
Other providers sharing the same authorized official: GARAY, MARY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
293 |
$46K |
| 2020 |
1,423 |
$217K |
| 2021 |
1,585 |
$285K |
| 2022 |
1,707 |
$297K |
| 2023 |
2,192 |
$338K |
| 2024 |
1,914 |
$389K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
7,515 |
5,696 |
$1.57M |
| D1120 |
Prophylaxis - child |
300 |
297 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
30 |
25 |
$0.00 |
| D1110 |
Prophylaxis - adult |
31 |
31 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
284 |
281 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
155 |
138 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
269 |
269 |
$0.00 |
| D1330 |
|
504 |
494 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
12 |
$0.00 |