SOUTHEAST MISSOURI HEALTH NETWORK
NPI: 1134340102
· SIKESTON, MO 63801
· General Practice Dentistry
· NPI assigned 05/01/2007
$474K
Total Medicaid Paid
Provider Details
| Authorized Official | JONES, CHRISTOPHER (CEO) |
| Parent Organization | SOUTHEAST MISSOURI HEALTH NETWORK |
| NPI Enumeration Date | 05/01/2007 |
Related Entities
Other providers sharing the same authorized official: JONES, CHRISTOPHER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
2,217 |
$180K |
| 2019 |
1,479 |
$131K |
| 2020 |
1,228 |
$99K |
| 2021 |
137 |
$11K |
| 2022 |
309 |
$33K |
| 2023 |
141 |
$14K |
| 2024 |
84 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D7140 |
Extraction, erupted tooth or exposed root |
2,357 |
754 |
$272K |
| D0330 |
Panoramic radiographic image |
607 |
540 |
$55K |
| D1110 |
Prophylaxis - adult |
577 |
539 |
$51K |
| D0140 |
Limited oral evaluation - problem focused |
511 |
474 |
$31K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
302 |
260 |
$18K |
| D0220 |
Intraoral - periapical first radiographic image |
717 |
614 |
$18K |
| D4341 |
|
63 |
12 |
$9K |
| D0272 |
Bitewings - two radiographic images |
272 |
245 |
$9K |
| D0274 |
Bitewings - four radiographic images |
162 |
127 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
27 |
26 |
$1K |