HOLLY TREE PEDIATRIC DENTISTRY
NPI: 1083008890
· SIMPSONVILLE, SC 29681
· 1223P0221X
$4.03M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
10,479 |
$314K |
| 2019 |
11,945 |
$379K |
| 2020 |
10,723 |
$334K |
| 2021 |
15,969 |
$506K |
| 2022 |
20,530 |
$698K |
| 2023 |
21,212 |
$670K |
| 2024 |
28,728 |
$1.13M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
21,593 |
21,593 |
$759K |
| D0120 |
|
19,818 |
19,818 |
$472K |
| D1206 |
|
25,350 |
25,350 |
$420K |
| D2392 |
|
3,570 |
2,373 |
$378K |
| D2930 |
|
1,944 |
1,192 |
$256K |
| D0272 |
|
11,463 |
11,463 |
$220K |
| D1110 |
|
4,285 |
4,285 |
$217K |
| D9230 |
|
6,053 |
5,963 |
$196K |
| D7140 |
|
1,757 |
1,014 |
$192K |
| D1351 |
|
5,817 |
1,702 |
$177K |
| D0150 |
|
3,959 |
3,959 |
$163K |
| D2391 |
|
1,632 |
1,229 |
$149K |
| D0145 |
|
2,547 |
2,547 |
$123K |
| D0330 |
|
1,987 |
1,987 |
$103K |
| D3220 |
|
843 |
535 |
$70K |
| D0220 |
|
4,513 |
4,489 |
$58K |
| D9223 |
|
265 |
123 |
$25K |
| D0140 |
|
458 |
457 |
$18K |
| D0230 |
|
1,537 |
648 |
$17K |
| D9222 |
|
123 |
123 |
$14K |
| D9310 |
|
72 |
72 |
$5K |