SOUTHEAST DENTAL CENTERS INC.
NPI: 1942328042
· CRAIG, AK 99921
· Dentist
· NPI assigned 03/27/2007
$198K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
795 |
$39K |
| 2019 |
826 |
$46K |
| 2020 |
324 |
$15K |
| 2021 |
319 |
$14K |
| 2022 |
775 |
$35K |
| 2023 |
469 |
$27K |
| 2024 |
371 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
618 |
579 |
$37K |
| D0120 |
Periodic oral evaluation - established patient |
828 |
742 |
$33K |
| D0274 |
Bitewings - four radiographic images |
620 |
560 |
$32K |
| D0330 |
Panoramic radiographic image |
363 |
323 |
$31K |
| D1206 |
Topical application of fluoride varnish |
819 |
732 |
$19K |
| D1110 |
Prophylaxis - adult |
242 |
208 |
$17K |
| D1120 |
Prophylaxis - child |
273 |
242 |
$15K |
| D2750 |
|
16 |
15 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
100 |
100 |
$2K |