Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › SD › PIERRE › DELTA DENTAL OF SOUTH DAKOTA FOUNDATION

DELTA DENTAL OF SOUTH DAKOTA FOUNDATION

NPI: 1124363957 · PIERRE, SD 57501 · Dental Clinic/Center · NPI assigned 12/05/2012

$595K
Total Medicaid Paid
18,969
Total Claims
15,525
Beneficiaries
6
Codes Billed
2018-01
First Month
2024-05
Last Month

Provider Details

Authorized OfficialHALVERSON, CONNIE (VP OF PUBLIC BENEFIT)
NPI Enumeration Date12/05/2012

Related Entities

Other providers sharing the same authorized official: HALVERSON, CONNIE

ProviderCityStateTotal Paid
DELTA DENTAL OF SOUTH DAKOTA FOUNDATION PIERRE SD $1.20M
DELTA DENTAL OF SOUTH DAKOTA FOUNDATION PIERRE SD $1.00M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 6,542 $195K
2019 3,691 $112K
2020 1,252 $38K
2021 3,162 $101K
2022 2,396 $72K
2024 1,926 $77K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 5,827 5,825 $229K
D1206 Topical application of fluoride varnish 6,789 6,786 $160K
D1351 Sealant - per tooth 4,832 1,732 $157K
D1353 618 280 $20K
D1330 703 703 $18K
D1110 Prophylaxis - adult 200 199 $11K