MAGNOLIA SMILES OF WIGGINS PLLC
NPI: 1649855115
· WIGGINS, MS 39577
· Dental Clinic/Center
· NPI assigned 03/16/2021
$149K
Total Medicaid Paid
Provider Details
| Authorized Official | JONES, OSCAR (OWNER) |
| NPI Enumeration Date | 03/16/2021 |
Related Entities
Other providers sharing the same authorized official: JONES, OSCAR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
1,090 |
$19K |
| 2023 |
1,967 |
$55K |
| 2024 |
2,676 |
$75K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,475 |
1,284 |
$42K |
| D1206 |
Topical application of fluoride varnish |
1,246 |
1,110 |
$29K |
| D1351 |
Sealant - per tooth |
719 |
96 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
623 |
583 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
397 |
311 |
$13K |
| D0274 |
Bitewings - four radiographic images |
382 |
347 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
112 |
94 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
372 |
351 |
$5K |
| D0330 |
Panoramic radiographic image |
139 |
95 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
222 |
168 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
46 |
41 |
$2K |