Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SOUTHERN DOMINION HEALTH SYSTEM, INC.

NPI: 1396995940 · VICTORIA, VA 23974 · Federally Qualified Health Center (FQHC) · NPI assigned 09/19/2008

$37K
Total Medicaid Paid
1,594
Total Claims
1,217
Beneficiaries
12
Codes Billed
2018-01
First Month
2019-08
Last Month

Provider Details

Authorized OfficialKING, APRIL (CEO)
Parent OrganizationSOUTHERN DOMINION HEALTH SYSTEM, INC.
NPI Enumeration Date09/19/2008

Related Entities

Other providers sharing the same authorized official: KING, APRIL

ProviderCityStateTotal Paid
SOUTHERN DOMINION HEALTH SYSTEM, INC. VICTORIA VA $829K
SOUTHERN DOMINION HEALTH SYSTEM, INC. VICTORIA VA $810K
SOUTHERN DOMINION HEALTH SYSTEM, INC. DINWIDDIE VA $802K
SOUTHERN DOMINION HEALTH SYSTEM, INC. AMELIA COURT HOUSE VA $574K
SOUTHERN DOMINION HEALTH SYSTEM, INC. EMPORIA VA $338K
DR. APRIL R. KING, OD, LLC RAINBOW CITY AL $54K
SOUTHERN DOMINION HEALTH SYSTEM, INC. VICTORIA VA $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 617 $14K
2019 977 $23K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 189 175 $8K
D7140 Extraction, erupted tooth or exposed root 160 37 $6K
D0150 Comprehensive oral evaluation - new or established patient 257 179 $5K
D0140 Limited oral evaluation - problem focused 279 191 $4K
D1120 Prophylaxis - child 109 108 $4K
D1208 Topical application of fluoride, excluding varnish 136 135 $3K
D0120 Periodic oral evaluation - established patient 140 138 $3K
D0220 Intraoral - periapical first radiographic image 201 134 $1K
D1206 Topical application of fluoride varnish 56 56 $1K
D0274 Bitewings - four radiographic images 39 39 $1K
D0330 Panoramic radiographic image 16 13 $431.92
D0210 Intraoral - complete series of radiographic images 12 12 $359.55