SOUTH WESTERN DENTAL
NPI: 1326136607
· SIOUX FALLS, SD 57108
· General Practice Dentistry
· NPI assigned 10/11/2006
$211K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
854 |
$45K |
| 2019 |
431 |
$22K |
| 2021 |
365 |
$20K |
| 2022 |
740 |
$40K |
| 2023 |
761 |
$42K |
| 2024 |
701 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9920 |
|
721 |
677 |
$80K |
| D1110 |
Prophylaxis - adult |
1,338 |
1,307 |
$75K |
| D0120 |
Periodic oral evaluation - established patient |
1,500 |
1,469 |
$46K |
| D1206 |
Topical application of fluoride varnish |
241 |
235 |
$7K |
| D0274 |
Bitewings - four radiographic images |
52 |
52 |
$2K |