Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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SOUTHGATE FAMILY DENTAL

NPI: 1124646781 · SOUTHGATE, MI 48195 · Dental Clinic/Center · NPI assigned 07/10/2020

$932.00
Total Medicaid Paid
36
Total Claims
36
Beneficiaries
2
Codes Billed
2020-07
First Month
2023-10
Last Month

Provider Details

Authorized OfficialCHAMBERLAIN, LISA (OFFICE MANAGER)
NPI Enumeration Date07/10/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 12 $275.00
2023 24 $657.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 24 24 $572.00
D0120 Periodic oral evaluation - established patient 12 12 $360.00