EXCEPTIONAL NEEDS DENTAL SERVICES (ENDS)
NPI: 1073676037
· PORTLAND, OR 97220
· Health Maintenance Organization
· NPI assigned 12/19/2006
$115K
Total Medicaid Paid
Provider Details
| Authorized Official | AYRES, TONIA (ADMINISTRATOR) |
| NPI Enumeration Date | 12/19/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
5,486 |
$108K |
| 2019 |
6,161 |
$3K |
| 2020 |
3,796 |
$900.00 |
| 2021 |
4,976 |
$2K |
| 2022 |
6,080 |
$3K |
| 2023 |
6,853 |
$0.00 |
| 2024 |
8,108 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
22,567 |
19,399 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
6,688 |
6,370 |
$12K |
| D9420 |
|
127 |
121 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
694 |
140 |
$8K |
| D1110 |
Prophylaxis - adult |
3,813 |
3,541 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,059 |
2,920 |
$4K |
| D9310 |
|
684 |
634 |
$3K |
| D4341 |
|
58 |
13 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
366 |
340 |
$2K |
| D1206 |
Topical application of fluoride varnish |
1,758 |
1,627 |
$455.00 |
| D0140 |
Limited oral evaluation - problem focused |
619 |
594 |
$318.00 |
| D0191 |
|
685 |
622 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
208 |
206 |
$0.00 |
| D4910 |
|
19 |
19 |
$0.00 |
| D9950 |
|
40 |
15 |
$0.00 |
| D9995 |
|
50 |
41 |
$0.00 |
| D4355 |
|
13 |
13 |
$0.00 |
| D5410 |
|
12 |
12 |
$0.00 |