Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › AL › KILLEN › SHOAL CREEK DENTAL

SHOAL CREEK DENTAL

NPI: 1194216861 · KILLEN, AL 35645 · Dental Clinic/Center · NPI assigned 05/29/2018

$2K
Total Medicaid Paid
90
Total Claims
79
Beneficiaries
5
Codes Billed
2023-01
First Month
2023-08
Last Month

Provider Details

Authorized OfficialEVANS, BRUCE (OWNER)
NPI Enumeration Date05/29/2018

Related Entities

Other providers sharing the same authorized official: EVANS, BRUCE

ProviderCityStateTotal Paid
UPPER PINE RIVER FIRE PROTECTION DISTRICT BAYFIELD CO $14K
SUPERIOR ANESTHETISTS ASSOCIATES, INC. TROY MI $1K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 90 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 27 27 $825.00
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 16 14 $299.20
D1206 Topical application of fluoride varnish 13 13 $260.00
D0274 Bitewings - four radiographic images 12 12 $126.00
D0220 Intraoral - periapical first radiographic image 22 13 $103.95