SOUTHGATE FAMILY DENTAL
NPI: 1124646781
· SOUTHGATE, MI 48195
· 261QD0000X
$932.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
12 |
$275.00 |
| 2023 |
24 |
$657.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
|
24 |
24 |
$572.00 |
| D0120 |
|
12 |
12 |
$360.00 |