THE VINE KIDS DENTAL
NPI: 1073073268
· BOZEMAN, MT 59715
· Pediatric Dentist
· NPI assigned 03/22/2019
$115K
Total Medicaid Paid
Provider Details
| Authorized Official | YOCHIM, JI MIN (PRESIDENT) |
| NPI Enumeration Date | 03/22/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
517 |
$11K |
| 2021 |
1,748 |
$41K |
| 2022 |
2,552 |
$64K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
855 |
814 |
$32K |
| D1206 |
Topical application of fluoride varnish |
1,270 |
1,045 |
$28K |
| D0120 |
Periodic oral evaluation - established patient |
409 |
398 |
$13K |
| D1310 |
|
314 |
306 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
426 |
396 |
$8K |
| D1330 |
|
326 |
317 |
$7K |
| D0230 |
Intraoral - periapical each additional radiographic image |
469 |
276 |
$5K |
| D9630 |
|
209 |
197 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
86 |
82 |
$3K |
| D0272 |
Bitewings - two radiographic images |
111 |
107 |
$2K |
| D0603 |
|
164 |
164 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
26 |
25 |
$1K |
| D1999 |
|
152 |
132 |
$71.40 |