SCOTTSBURG FAMILY DENTISTRY LLC

NPI: 1790245504 · SCOTTSBURG, IN 47170 · General Practice Dentistry · NPI assigned 03/20/2019

$73K

Total Medicaid Paid

2,710

Total Claims

2,151

Beneficiaries

Codes Billed

2019-05

First Month

2024-11

Last Month

Provider Details

Authorized Official	LITTLE, WILLIAM (CO-OWNER)
NPI Enumeration Date	03/20/2019

Other providers sharing the same authorized official: LITTLE, WILLIAM

Provider	City	State	Total Paid
SOUTHERN DENTAL GROUP, PLLC	WYNNE	AR	$447K
PARIS DENTAL CLINIC PLLC	PARIS	AR	$285K
GPS NEAVILLE FAMILY DENTISTRY PLLC	SEARCY	AR	$229K
SOUTHERN DENTAL GROUP BALD KNOB, PLLC	BALD KNOB	AR	$203K
SOUTHERN DENTAL OF HILLTOP PLLC	JONESBORO	AR	$58K
SOUTHERN DENTAL OF HOT SPRINGS PLLC	HOT SPRINGS VILLAGE	AR	$35K
SAL DENTISTRY PLLC D/B/A FRIDDLE DENTISTRY	FORT SMITH	AR	$19K
WILLIAM R LITTLE DDS PLLC	JONESBORO	AR	$15K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	497	446	$23K
D0120	Periodic oral evaluation - established patient	725	667	$17K
D0274	Bitewings - four radiographic images	360	330	$12K
D0150	Comprehensive oral evaluation - new or established patient	204	153	$6K
D0330	Panoramic radiographic image	92	77	$4K
D0210	Intraoral - complete series of radiographic images	187	69	$4K
D0220	Intraoral - periapical first radiographic image	365	241	$3K
D0140	Limited oral evaluation - problem focused	95	67	$3K
D1208	Topical application of fluoride, excluding varnish	82	52	$1K
D0230	Intraoral - periapical each additional radiographic image	83	37	$464.00
D1120	Prophylaxis - child	20	12	$448.50