DALLIN C. YOUNG, D.D.D, P.A.

$137K

Total Medicaid Paid

7,316

Total Claims

6,361

Beneficiaries

22

Codes Billed

2018-01

First Month

2018-05

Last Month

Authorized Official	YOUNG, DALLIN (PRESIDENT)
NPI Enumeration Date	07/01/2008

Provider	City	State	Total Paid
YOUNG SMILES CHILDREN'S DENTISTRY LLC	FAIRBANKS	AK	$2.82M

Year	Claims	Total Paid
2018	7,316	$137K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	1,062	1,062	$67K
D1110	Prophylaxis - adult	276	276	$24K
D0330	Panoramic radiographic image	238	238	$16K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	234	140	$11K
D2930	Prefabricated stainless steel crown - primary tooth	257	64	$6K
D1351	Sealant - per tooth	699	152	$5K
D2391	Resin-based composite - one surface, posterior, primary or permanent	77	57	$2K
D0210	Intraoral - complete series of radiographic images	13	13	$2K
D9420		13	13	$1K
D2330		20	12	$894.26
D7140	Extraction, erupted tooth or exposed root	39	27	$816.60
D0140	Limited oral evaluation - problem focused	25	24	$679.25
D0120	Periodic oral evaluation - established patient	1,040	1,040	$643.43
D0150	Comprehensive oral evaluation - new or established patient	153	153	$318.69
D0274	Bitewings - four radiographic images	120	120	$113.22
D0220	Intraoral - periapical first radiographic image	327	323	$55.32
D0145	Oral evaluation for a patient under three years of age	127	127	$41.45
D0272	Bitewings - two radiographic images	786	785	$15.96
D1208	Topical application of fluoride, excluding varnish	555	555	$13.55
D1206	Topical application of fluoride varnish	801	801	$13.55
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	255	249	$0.00
D0230	Intraoral - periapical each additional radiographic image	199	130	$0.00

Medicaid Provider Spending