LAKE CITY FAMILY DENTISTRY
NPI: 1770671968
· LAKE CITY, SC 29560
· Dentist
· NPI assigned 10/11/2006
$312K
Total Medicaid Paid
Provider Details
| Authorized Official | HOBBS, WINDY (ACCOUNTS PAYABLE) |
| NPI Enumeration Date | 10/11/2006 |
Related Entities
Other providers sharing the same authorized official: HOBBS, WINDY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,535 |
$42K |
| 2019 |
130 |
$4K |
| 2020 |
2,567 |
$80K |
| 2021 |
2,223 |
$64K |
| 2022 |
1,953 |
$56K |
| 2023 |
1,420 |
$40K |
| 2024 |
873 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,288 |
2,288 |
$114K |
| D0274 |
Bitewings - four radiographic images |
1,972 |
1,972 |
$54K |
| D0120 |
Periodic oral evaluation - established patient |
2,236 |
2,236 |
$51K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,022 |
3,022 |
$49K |
| D1120 |
Prophylaxis - child |
424 |
424 |
$15K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
83 |
53 |
$9K |
| D0272 |
Bitewings - two radiographic images |
440 |
440 |
$8K |
| D0330 |
Panoramic radiographic image |
103 |
103 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
94 |
94 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
39 |
25 |
$3K |