JACKSON PEDIATRIC DENTISTRY OF SUMMERVILLE
NPI: 1962981142
· SUMMERVILLE, SC 29483
· 1223P0221X
$443K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$486.00 |
| 2019 |
490 |
$13K |
| 2020 |
1,350 |
$39K |
| 2021 |
2,995 |
$76K |
| 2022 |
3,849 |
$104K |
| 2023 |
3,656 |
$92K |
| 2024 |
4,003 |
$118K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
2,789 |
2,789 |
$92K |
| D1206 |
|
3,365 |
3,365 |
$52K |
| D0120 |
|
2,263 |
2,263 |
$50K |
| D9230 |
|
1,502 |
1,324 |
$46K |
| D2930 |
|
306 |
110 |
$39K |
| D0272 |
|
1,737 |
1,737 |
$31K |
| D2392 |
|
227 |
122 |
$23K |
| D0150 |
|
472 |
472 |
$19K |
| D0140 |
|
481 |
479 |
$18K |
| D0220 |
|
1,344 |
1,324 |
$17K |
| D1110 |
|
364 |
364 |
$16K |
| D0145 |
|
256 |
256 |
$15K |
| D0230 |
|
909 |
596 |
$9K |
| D7140 |
|
79 |
39 |
$8K |
| D1351 |
|
108 |
36 |
$3K |
| D9310 |
|
47 |
47 |
$3K |
| D0330 |
|
50 |
50 |
$2K |
| D0274 |
|
44 |
44 |
$1K |
| D1208 |
|
12 |
12 |
$145.80 |