SQUAXIN ISLAND DENTAL CLINIC ENCOUNTER
NPI: 1003021338
· SHELTON, WA 98584
· Dental Clinic/Center
· NPI assigned 05/11/2007
$1.12M
Total Medicaid Paid
Provider Details
| Authorized Official | JONES, WHITNEY (DIRECTOR) |
| NPI Enumeration Date | 05/11/2007 |
Related Entities
Other providers sharing the same authorized official: JONES, WHITNEY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
149 |
$38K |
| 2019 |
305 |
$77K |
| 2020 |
210 |
$58K |
| 2021 |
913 |
$198K |
| 2022 |
705 |
$236K |
| 2023 |
1,056 |
$281K |
| 2024 |
703 |
$237K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,754 |
2,325 |
$1.10M |
| D1206 |
Topical application of fluoride varnish |
506 |
483 |
$9K |
| D1110 |
Prophylaxis - adult |
111 |
106 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
146 |
124 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
307 |
292 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
80 |
76 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
41 |
41 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
25 |
25 |
$926.26 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$160.86 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
25 |
$93.48 |
| D0190 |
|
12 |
12 |
$0.00 |
| D1330 |
|
21 |
18 |
$0.00 |