FREEMAN DENTISTRY OF SOUTH CAROLINA LLC
NPI: 1093390007
· COLUMBIA, SC 29201
· Dentist
· NPI assigned 03/11/2021
$123K
Total Medicaid Paid
Provider Details
| Authorized Official | FREEMAN, ROURK (OWNER) |
| NPI Enumeration Date | 03/11/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
1,070 |
$47K |
| 2023 |
1,097 |
$44K |
| 2024 |
855 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,201 |
1,201 |
$48K |
| D1110 |
Prophylaxis - adult |
839 |
839 |
$42K |
| D0210 |
Intraoral - complete series of radiographic images |
413 |
413 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
492 |
492 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
46 |
46 |
$590.18 |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
31 |
$322.09 |