SANDUSKY DENTAL CARE, PLC
NPI: 1093910077
· SANDUSKY, MI 48471
· General Practice Dentistry
· NPI assigned 06/19/2007
$203K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,037 |
$31K |
| 2019 |
924 |
$26K |
| 2020 |
871 |
$23K |
| 2021 |
1,122 |
$31K |
| 2022 |
1,073 |
$30K |
| 2023 |
1,121 |
$35K |
| 2024 |
841 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,021 |
2,021 |
$78K |
| D0120 |
Periodic oral evaluation - established patient |
2,145 |
2,144 |
$56K |
| D1206 |
Topical application of fluoride varnish |
2,247 |
2,246 |
$53K |
| D0272 |
Bitewings - two radiographic images |
316 |
316 |
$7K |
| D1110 |
Prophylaxis - adult |
127 |
127 |
$6K |
| D0274 |
Bitewings - four radiographic images |
36 |
36 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
37 |
37 |
$612.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$534.00 |
| D1999 |
|
48 |
47 |
$0.00 |