Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › AZ › SAN TAN VALLEY › SUN WEST DENTAL SAN TAN

SUN WEST DENTAL SAN TAN

NPI: 1821459421 · SAN TAN VALLEY, AZ 85143 · General Practice Dentistry · NPI assigned 03/10/2016

$2K
Total Medicaid Paid
242
Total Claims
232
Beneficiaries
5
Codes Billed
2020-05
First Month
2022-09
Last Month

Provider Details

Authorized OfficialDALTON, TRACEY (CREDENTIALING SPECIALIST)
NPI Enumeration Date03/10/2016

Related Entities

Other providers sharing the same authorized official: DALTON, TRACEY

ProviderCityStateTotal Paid
SUN WEST DENTAL IV, LLC SURPRISE AZ $55K
SUNWEST DENTAL CENTER III, LLC TEMPE AZ $12K
SUN WEST DENTAL III, LLC APACHE JUNCTION AZ $3K
SUNWEST DENTAL CENTER, III LLC PRESCOTT VALLEY AZ $1K
SUN WEST DENTAL CENTER III, LLC BUCKEYE AZ $777.00
TEMPE SMILES FAMILY DENTAL, PC TEMPE AZ $541.64
SUN WEST DENTAL III, LLC DBA SUN WEST DENTAL CHANDLER AZ $110.00
SUN WEST DENTAL III, LLC MESA AZ $40.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 13 $51.01
2021 47 $166.47
2022 182 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 124 117 $572.94
D0330 Panoramic radiographic image 28 27 $315.36
D0230 Intraoral - periapical each additional radiographic image 63 61 $244.27
D0150 Comprehensive oral evaluation - new or established patient 12 12 $230.73
D0274 Bitewings - four radiographic images 15 15 $184.23