SOUTHERN DENTAL CARE, LLC
NPI: 1992115919
· MARRERO, LA 70072
· General Practice Dentistry
· NPI assigned 04/29/2014
Provider Details
| Authorized Official | ANDREOTTA, LACEY (OWNER, DENTIST) |
| NPI Enumeration Date | 04/29/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
635 |
$17K |
| 2022 |
535 |
$13K |
| 2023 |
224 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
631 |
560 |
$14K |
| D1110 |
Prophylaxis - adult |
267 |
233 |
$10K |
| D1120 |
Prophylaxis - child |
160 |
146 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
212 |
191 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$722.04 |
| D0272 |
Bitewings - two radiographic images |
28 |
27 |
$578.61 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$568.44 |
| D0220 |
Intraoral - periapical first radiographic image |
57 |
43 |
$484.77 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
14 |
$136.62 |