SOUTHSIDE DENTAL CARES, PC
NPI: 1962154252
· PETERSBURG, VA 23805
· Dental Clinic/Center
· NPI assigned 01/19/2022
Provider Details
| Authorized Official | HEPNER, BARBARA (MANAGER) |
| NPI Enumeration Date | 01/19/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
396 |
$9K |
| 2023 |
341 |
$5K |
| 2024 |
38 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
208 |
205 |
$3K |
| D9630 |
|
202 |
199 |
$3K |
| D1110 |
Prophylaxis - adult |
63 |
63 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
92 |
92 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
80 |
41 |
$987.83 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
25 |
25 |
$904.82 |
| D0274 |
Bitewings - four radiographic images |
27 |
27 |
$825.24 |
| D0220 |
Intraoral - periapical first radiographic image |
66 |
66 |
$516.42 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$402.24 |