Home ›
IN ›
AVON ›
10439 E US HIGHWAY 36 DENTAL, LLC
10439 E US HIGHWAY 36 DENTAL, LLC
NPI: 1023546629
· AVON, IN 46123
· General Practice Dentistry
· NPI assigned 05/25/2017
$115K
Total Medicaid Paid
Provider Details
| Authorized Official | MERTES, ALLEE (DIRECTOR OF COMPLIANCE) |
| NPI Enumeration Date | 05/25/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,928 |
$68K |
| 2019 |
997 |
$47K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
659 |
273 |
$54K |
| D7140 |
Extraction, erupted tooth or exposed root |
731 |
238 |
$26K |
| D0140 |
Limited oral evaluation - problem focused |
1,157 |
942 |
$19K |
| D0330 |
Panoramic radiographic image |
387 |
314 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
118 |
88 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
802 |
645 |
$4K |
| D0270 |
|
32 |
30 |
$620.78 |
| D0230 |
Intraoral - periapical each additional radiographic image |
39 |
25 |
$30.00 |