SOUTH LANE CHILDREN'S DENTAL CLINIC
NPI: 1497190821
· COTTAGE GROVE, OR 97424
· Voluntary or Charitable Agency
· NPI assigned 04/29/2013
Provider Details
| Authorized Official | LONG, COURTNEY (DENTAL CARE COORDINATOR) |
| Parent Organization | SOUTH LANE SCHOOL DISTRICT |
| NPI Enumeration Date | 04/29/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,919 |
$14K |
| 2019 |
709 |
$5K |
| 2020 |
410 |
$3K |
| 2021 |
298 |
$456.29 |
| 2022 |
961 |
$7K |
| 2023 |
535 |
$4K |
| 2024 |
153 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
1,398 |
313 |
$17K |
| D1206 |
Topical application of fluoride varnish |
625 |
593 |
$7K |
| D0191 |
|
649 |
631 |
$7K |
| D0601 |
|
296 |
288 |
$3K |
| D0603 |
|
158 |
146 |
$2K |
| D1310 |
|
719 |
684 |
$0.00 |
| D1320 |
|
390 |
367 |
$0.00 |
| D1330 |
|
733 |
695 |
$0.00 |
| D0602 |
|
17 |
16 |
$0.00 |