SOUTHCENTRAL FOUNDATION
NPI: 1922555820
· ST PAUL, AK 99660
· General Practice Dentistry
· NPI assigned 09/08/2016
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official OLSON, RONALD controls 20+ related entities in our dataset. Read more
$146K
Total Medicaid Paid
Provider Details
| Authorized Official | OLSON, RONALD (EXECUTIVE VICE PRESIDENT FINANCE) |
| Parent Organization | SOUTHCENTRAL FOUNDATION |
| NPI Enumeration Date | 09/08/2016 |
Related Entities
Other providers sharing the same authorized official: OLSON, RONALD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
282 |
$48K |
| 2019 |
196 |
$33K |
| 2021 |
42 |
$0.00 |
| 2022 |
580 |
$20K |
| 2023 |
65 |
$0.00 |
| 2024 |
175 |
$45K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
322 |
259 |
$127K |
| D1120 |
Prophylaxis - child |
213 |
157 |
$11K |
| D0272 |
Bitewings - two radiographic images |
18 |
18 |
$4K |
| D1206 |
Topical application of fluoride varnish |
330 |
247 |
$2K |
| D1351 |
Sealant - per tooth |
337 |
66 |
$1K |
| D0274 |
Bitewings - four radiographic images |
55 |
26 |
$180.81 |
| D0140 |
Limited oral evaluation - problem focused |
21 |
13 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
44 |
15 |
$0.00 |