SOUTHCENTRAL FOUNDATION
NPI: 1497202550
· MCGRATH, AK 99627
· General Practice Dentistry
· NPI assigned 09/07/2016
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official OLSON, RONALD controls 20+ related entities in our dataset. Read more
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | OLSON, RONALD (EXECUTIVE VICE PRESIDENT FINANCE) |
| Parent Organization | SOUTHCENTRAL FOUNDATION |
| NPI Enumeration Date | 09/07/2016 |
Related Entities
Other providers sharing the same authorized official: OLSON, RONALD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
186 |
$22K |
| 2019 |
206 |
$44K |
| 2020 |
12 |
$4K |
| 2021 |
35 |
$11K |
| 2022 |
23 |
$9K |
| 2023 |
177 |
$37K |
| 2024 |
27 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
234 |
208 |
$87K |
| D1206 |
Topical application of fluoride varnish |
171 |
155 |
$17K |
| D1110 |
Prophylaxis - adult |
40 |
39 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
23 |
17 |
$9K |
| D0274 |
Bitewings - four radiographic images |
57 |
44 |
$1K |
| D1120 |
Prophylaxis - child |
63 |
60 |
$1K |
| D1351 |
Sealant - per tooth |
66 |
17 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |