ST. Luke's Family Health Center

ST. Luke's Family Health Center was paid $304K by Medicaid between Jan 2022 and Nov 2024, across 20 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 29% of everything it billed.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2022	2,300	$56K
2023	6,071	$180K
2024incomplete	2,808	$67K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2930	Prefabricated stainless steel crown - primary tooth	29%	805	244	$89K
D1120	Dental cleaning, childProphylaxis - child	21%	2,336	2,336	$64K
D1206	Topical application of fluoride varnish	15%	2,721	2,718	$46K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	11%	1,894	1,894	$35K
D1351	Sealant - per tooth	7.4%	948	266	$22K
D0210	Intraoral - complete series of radiographic images	3.4%	196	196	$10K
D0150	Comprehensive oral evaluation - new or established patient	2.9%	342	342	$9K
D0274	Bitewings - four radiographic images	2.6%	512	512	$8K
D0330	Panoramic radiographic image	1.6%	312	312	$5K
D0220	Intraoral - periapical first radiographic image	1.2%	462	456	$4K
D0272	Bitewings - two radiographic images	<1%	246	246	$3K
D7140	Extraction, erupted tooth or exposed root	<1%	44	27	$2K

8 more codes

D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	44	$2K
D1110	Prophylaxis - adult	<1%	49	$2K
D1353		<1%	29	$550.39
D0190		<1%	30	$447.60
D0230	Intraoral - periapical each additional radiographic image	<1%	101	$398.85
D1354		<1%	81	$339.70
D0140	Limited oral evaluation - problem focused	<1%	13	$337.80
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	<1%	14	$303.29

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialCAMPBELL, VALERIE (NURSE MANAGER)