Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WA › TUKWILA › SOUTH CENTER PEDIATRIC DENTISTRY AND ORTHODONTICS LLC

SOUTH CENTER PEDIATRIC DENTISTRY AND ORTHODONTICS LLC

NPI: 1275996191 · TUKWILA, WA 98188 · Pediatric Dentist · NPI assigned 03/29/2016

$6.85M
Total Medicaid Paid
259,316
Total Claims
189,588
Beneficiaries
30
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialVIRK, MAHADEEP (OWNER OPERATOR)
NPI Enumeration Date03/29/2016

Related Entities

Other providers sharing the same authorized official: VIRK, MAHADEEP

ProviderCityStateTotal Paid
NORTH TACOMA PEDIATRIC DENTISTRY AND ORTHODONTICS LLC TACOMA WA $2.46M
COVINGTON ORTHODONTICS AND PEDIATRIC DENTISTRY L.L.C. COVINGTON WA $219K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 23,908 $427K
2019 37,811 $743K
2020 37,914 $685K
2021 33,000 $669K
2022 43,029 $1.01M
2023 40,135 $1.50M
2024 43,519 $1.81M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2930 Prefabricated stainless steel crown - primary tooth 8,326 2,151 $1.33M
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 9,270 4,732 $638K
D0120 Periodic oral evaluation - established patient 22,083 21,796 $579K
D1120 Prophylaxis - child 24,175 23,863 $558K
D1208 Topical application of fluoride, excluding varnish 25,746 25,401 $493K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 4,188 1,309 $430K
D2391 Resin-based composite - one surface, posterior, primary or permanent 6,501 3,500 $367K
D9630 7,802 7,684 $344K
D2390 1,203 349 $339K
D7140 Extraction, erupted tooth or exposed root 4,361 2,180 $244K
D0220 Intraoral - periapical first radiographic image 25,554 24,880 $206K
D0150 Comprehensive oral evaluation - new or established patient 4,792 4,690 $184K
D9999 Unspecified adjunctive procedure, by report 5,664 5,572 $168K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 7,612 7,111 $163K
D0272 Bitewings - two radiographic images 16,556 16,279 $162K
D0230 Intraoral - periapical each additional radiographic image 66,354 23,731 $154K
D0330 Panoramic radiographic image 4,471 4,365 $149K
D1351 Sealant - per tooth 5,683 1,721 $120K
D1110 Prophylaxis - adult 1,934 1,885 $76K
D0140 Limited oral evaluation - problem focused 2,918 2,836 $61K
D1999 2,840 2,609 $38K
D3230 254 90 $17K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 191 153 $13K
D7111 172 122 $5K
D0274 Bitewings - four radiographic images 434 418 $5K
D2330 19 13 $1K
D9920 40 38 $898.32
D1206 Topical application of fluoride varnish 31 30 $458.46
D1354 114 52 $342.00
D9996 28 28 $289.00