BACON, TRACY
NPI: 1023099959
· SOUTH BEND, IN 46617
· Dentist
· NPI assigned 11/08/2005
$114K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
272 |
$2K |
| 2019 |
304 |
$9K |
| 2020 |
571 |
$18K |
| 2021 |
733 |
$23K |
| 2022 |
747 |
$25K |
| 2023 |
649 |
$19K |
| 2024 |
462 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,420 |
1,350 |
$62K |
| D0120 |
Periodic oral evaluation - established patient |
1,502 |
1,425 |
$32K |
| D0274 |
Bitewings - four radiographic images |
414 |
385 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
402 |
383 |
$7K |