SOUTH SOONER DENTAL PARTNERS
NPI: 1316458383
· MOORE, OK 73160
· 1223G0001X
$392K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
598 |
$9K |
| 2022 |
5,087 |
$109K |
| 2023 |
7,048 |
$141K |
| 2024 |
6,294 |
$134K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
|
4,548 |
4,266 |
$70K |
| D1110 |
|
1,298 |
1,245 |
$60K |
| D0274 |
|
1,530 |
1,472 |
$48K |
| D0230 |
|
5,851 |
3,423 |
$46K |
| D0120 |
|
2,006 |
1,920 |
$42K |
| D0140 |
|
1,353 |
1,290 |
$41K |
| D1206 |
|
1,392 |
1,330 |
$23K |
| D2392 |
|
154 |
79 |
$17K |
| D7210 |
|
109 |
38 |
$13K |
| D0150 |
|
348 |
329 |
$10K |
| D1120 |
|
333 |
332 |
$10K |
| D2394 |
|
35 |
25 |
$5K |
| D0210 |
|
52 |
50 |
$3K |
| D2393 |
|
18 |
12 |
$3K |