PARK VIEW FAMILY DENTISTRY
NPI: 1104256387
· BOYNE CITY, MI 49712
· Dentist
· NPI assigned 11/25/2013
$101K
Total Medicaid Paid
Provider Details
| Authorized Official | LARSON, JENNIFER (PRESIDENT / OWNER) |
| NPI Enumeration Date | 11/25/2013 |
Related Entities
Other providers sharing the same authorized official: LARSON, JENNIFER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
124 |
$3K |
| 2021 |
436 |
$13K |
| 2022 |
520 |
$17K |
| 2023 |
857 |
$30K |
| 2024 |
892 |
$37K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
584 |
583 |
$30K |
| D0120 |
Periodic oral evaluation - established patient |
976 |
976 |
$26K |
| D1120 |
Prophylaxis - child |
379 |
379 |
$15K |
| D1206 |
Topical application of fluoride varnish |
445 |
445 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
52 |
39 |
$7K |
| D0274 |
Bitewings - four radiographic images |
124 |
124 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
42 |
42 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
60 |
60 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
76 |
75 |
$1K |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$697.50 |
| D0230 |
Intraoral - periapical each additional radiographic image |
79 |
60 |
$639.91 |