SOUTHWOOD FAMILY DENTAL PC
NPI: 1770012726
· HEMPSTEAD, NY 11550
· Dental Clinic/Center
· NPI assigned 06/05/2017
$135K
Total Medicaid Paid
Provider Details
| Authorized Official | SOH, JUNGHWAN (PRESIDENT) |
| NPI Enumeration Date | 06/05/2017 |
Related Entities
Other providers sharing the same authorized official: SOH, JUNGHWAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,540 |
$27K |
| 2019 |
1,664 |
$31K |
| 2020 |
2,125 |
$38K |
| 2021 |
2,309 |
$40K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,080 |
1,077 |
$42K |
| D0120 |
Periodic oral evaluation - established patient |
1,396 |
1,392 |
$29K |
| D0274 |
Bitewings - four radiographic images |
1,233 |
1,233 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
1,828 |
1,812 |
$18K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,590 |
1,586 |
$11K |
| D1120 |
Prophylaxis - child |
157 |
157 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
45 |
37 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
169 |
169 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
47 |
47 |
$788.83 |
| D0140 |
Limited oral evaluation - problem focused |
79 |
76 |
$762.72 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$279.00 |