CHICOT MEMORIAL MEDICAL CENTER
NPI: 1861901985
· LAKE VILLAGE, AR 71653
· Dental Clinic/Center
· NPI assigned 09/20/2017
$370K
Total Medicaid Paid
Provider Details
| Authorized Official | VAUGHN, SUSAN (CFO) |
| Parent Organization | CHICOT MEMORIAL MEDICAL CENTER |
| NPI Enumeration Date | 09/20/2017 |
Related Entities
Other providers sharing the same authorized official: VAUGHN, SUSAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
828 |
$32K |
| 2019 |
939 |
$33K |
| 2020 |
896 |
$28K |
| 2021 |
2,114 |
$80K |
| 2022 |
2,327 |
$75K |
| 2023 |
2,239 |
$71K |
| 2024 |
1,849 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
|
1,548 |
1,456 |
$69K |
| D7140 |
|
1,001 |
268 |
$68K |
| D0120 |
|
2,250 |
2,153 |
$56K |
| D1120 |
|
1,279 |
1,249 |
$44K |
| D1208 |
|
2,019 |
1,954 |
$39K |
| D0140 |
|
1,268 |
1,148 |
$38K |
| D0272 |
|
1,196 |
1,145 |
$27K |
| D0210 |
|
228 |
210 |
$18K |
| D0330 |
|
80 |
69 |
$4K |
| D0220 |
|
205 |
189 |
$3K |
| D0150 |
|
53 |
43 |
$2K |
| D2150 |
|
17 |
12 |
$1K |
| D0603 |
|
48 |
32 |
$210.00 |