Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › VA › COLONIAL HEIGHTS › SOUTHSIDE FAMILY AND COSMETIC DENTISTRY

SOUTHSIDE FAMILY AND COSMETIC DENTISTRY

NPI: 1295008985 · COLONIAL HEIGHTS, VA 23834 · General Practice Dentistry · NPI assigned 02/12/2012

$5K
Total Medicaid Paid
204
Total Claims
204
Beneficiaries
5
Codes Billed
2018-01
First Month
2018-03
Last Month

Provider Details

Authorized OfficialPARRIS-WILKINS, TONYA (PRESIDENT)
NPI Enumeration Date02/12/2012

Related Entities

Other providers sharing the same authorized official: PARRIS-WILKINS, TONYA

ProviderCityStateTotal Paid
BLAND MINISTRY CENTER AND DENTAL CLINIC WYTHEVILLE VA $306K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 204 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 75 75 $1K
D1120 Prophylaxis - child 38 38 $1K
D0120 Periodic oral evaluation - established patient 56 56 $1K
D1110 Prophylaxis - adult 14 14 $574.47
D9630 21 21 $417.27