Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › UT › SOUTH JORDAN › SJ ORAL SURGERY PC

SJ ORAL SURGERY PC

NPI: 1316442841 · SOUTH JORDAN, UT 84009 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 03/27/2018

$2K
Total Medicaid Paid
39
Total Claims
39
Beneficiaries
3
Codes Billed
2020-09
First Month
2020-09
Last Month

Provider Details

Authorized OfficialJENSEN, DAYNE (PRESIDENT)
NPI Enumeration Date03/27/2018

Related Entities

Other providers sharing the same authorized official: JENSEN, DAYNE

ProviderCityStateTotal Paid
YUMA SONOMA ORAL SURGERY, P.C. YUMA AZ $450K
CHEYENNE MOUNTAIN ORAL SURGERY PC COLORADO SPRINGS CO $15K
ALBUQUERQUE ORAL SURGERY, P.C. ALBUQUERQUE NM $4K
GILBERT SONOMA ORAL SURGERY, P.C. GILBERT AZ $2K
ST. GEORGE RED ROCKS PC ST GEORGE UT $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 39 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 15 15 $2K
D1206 Topical application of fluoride varnish 12 12 $0.00
D1120 Prophylaxis - child 12 12 $0.00