PROVIDENCE HEALTH & SERVICES-OREGON
NPI: 1124343215
· PORTLAND, OR 97213
· Dental Clinic/Center
· NPI assigned 03/31/2010
$213K
Total Medicaid Paid
7,944
Beneficiary Records
Provider Details
| Authorized Official | BUDO, PATRICIA (OPERATIONS ADMINISTRATOR) |
| NPI Enumeration Date | 03/31/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,818 |
$70K |
| 2019 |
2,853 |
$71K |
| 2020 |
1,028 |
$19K |
| 2021 |
1,055 |
$27K |
| 2022 |
197 |
$8K |
| 2023 |
375 |
$18K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,429 |
2,378 |
$87K |
| D0120 |
Periodic oral evaluation - established patient |
2,396 |
2,355 |
$65K |
| D1206 |
Topical application of fluoride varnish |
2,047 |
2,017 |
$37K |
| D0140 |
Limited oral evaluation - problem focused |
219 |
213 |
$7K |
| D0272 |
Bitewings - two radiographic images |
300 |
285 |
$5K |
| D1351 |
Sealant - per tooth |
161 |
49 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
255 |
242 |
$3K |
| D0603 |
|
232 |
231 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
41 |
39 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
97 |
39 |
$678.80 |
| D0601 |
|
56 |
54 |
$539.30 |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$517.00 |
| D0240 |
|
28 |
13 |
$408.00 |
| D1354 |
|
51 |
15 |
$239.63 |