CHUGACHMIUT
NPI: 1316147069
· SEWARD, AK 99664
· Dentist
· NPI assigned 07/20/2007
$453K
Total Medicaid Paid
Provider Details
| Authorized Official | BAKER, KELLEY (HEALTH SERVICES DIVISION DIRECTOR) |
| NPI Enumeration Date | 07/20/2007 |
Related Entities
Other providers sharing the same authorized official: BAKER, KELLEY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,146 |
$42K |
| 2019 |
852 |
$54K |
| 2020 |
602 |
$36K |
| 2021 |
919 |
$50K |
| 2022 |
791 |
$119K |
| 2023 |
448 |
$93K |
| 2024 |
326 |
$59K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
257 |
242 |
$157K |
| D1110 |
Prophylaxis - adult |
626 |
588 |
$140K |
| D1206 |
Topical application of fluoride varnish |
673 |
617 |
$50K |
| D0220 |
Intraoral - periapical first radiographic image |
51 |
47 |
$29K |
| D0120 |
Periodic oral evaluation - established patient |
130 |
121 |
$26K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
82 |
68 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
39 |
35 |
$16K |
| D1351 |
Sealant - per tooth |
97 |
31 |
$8K |
| D0274 |
Bitewings - four radiographic images |
137 |
126 |
$7K |
| D2940 |
|
33 |
12 |
$2K |
| D1354 |
|
2,211 |
354 |
$0.00 |
| D1330 |
|
715 |
671 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
33 |
31 |
$0.00 |