CITY OF SIOUX FALLS
NPI: 1902130818
· SIOUX FALLS, SD 57103
· Federally Qualified Health Center (FQHC)
· NPI assigned 09/24/2009
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | RICHARDSON, AMY (ASSISTANT PUBLIC HEALTH DIRECTOR) |
| NPI Enumeration Date | 09/24/2009 |
Related Entities
Other providers sharing the same authorized official: RICHARDSON, AMY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
406 |
$38K |
| 2019 |
156 |
$18K |
| 2021 |
64 |
$8K |
| 2022 |
260 |
$30K |
| 2023 |
142 |
$16K |
| 2024 |
135 |
$16K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
747 |
626 |
$79K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
153 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
77 |
62 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
40 |
27 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23 |
20 |
$3K |
| D0272 |
Bitewings - two radiographic images |
103 |
73 |
$364.70 |
| 90656 |
|
14 |
14 |
$0.00 |