RACINE DENTAL GROUP S C
NPI: 1801941570
· RACINE, WI 53406
· General Practice Dentistry
· NPI assigned 01/24/2007
$104K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,235 |
$26K |
| 2019 |
1,297 |
$24K |
| 2020 |
1,022 |
$22K |
| 2021 |
1,454 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,043 |
2,002 |
$37K |
| D1120 |
Prophylaxis - child |
846 |
816 |
$23K |
| D1206 |
Topical application of fluoride varnish |
1,314 |
1,279 |
$22K |
| D1110 |
Prophylaxis - adult |
679 |
667 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
36 |
36 |
$2K |
| D0274 |
Bitewings - four radiographic images |
50 |
50 |
$1K |
| D0272 |
Bitewings - two radiographic images |
16 |
16 |
$272.01 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$253.69 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$144.10 |