GREAT LAKES BAY HEALTH CENTERS
NPI: 1902136385
· VASSAR, MI 48768
· Federally Qualified Health Center (FQHC)
· NPI assigned 01/06/2010
$231K
Total Medicaid Paid
Provider Details
| Authorized Official | GALONASKA, LISA (VICE PRESIDENT) |
| NPI Enumeration Date | 01/06/2010 |
Related Entities
Other providers sharing the same authorized official: GALONASKA, LISA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
895 |
$74K |
| 2019 |
869 |
$77K |
| 2020 |
491 |
$52K |
| 2021 |
139 |
$20K |
| 2022 |
108 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
574 |
574 |
$70K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
551 |
549 |
$53K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
276 |
223 |
$42K |
| D0120 |
Periodic oral evaluation - established patient |
198 |
198 |
$28K |
| D2140 |
|
121 |
112 |
$17K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
57 |
48 |
$10K |
| D0274 |
Bitewings - four radiographic images |
674 |
672 |
$9K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
12 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
39 |
39 |
$221.00 |