DOWNTOWN DENTAL GP
NPI: 1124405030
· JAMESTOWN, ND 58401
· Dentist
· NPI assigned 04/29/2015
$114K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
441 |
$11K |
| 2019 |
278 |
$8K |
| 2020 |
646 |
$15K |
| 2021 |
952 |
$24K |
| 2022 |
744 |
$19K |
| 2023 |
731 |
$21K |
| 2024 |
519 |
$16K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,030 |
1,874 |
$48K |
| D1110 |
Prophylaxis - adult |
501 |
462 |
$23K |
| D1206 |
Topical application of fluoride varnish |
1,034 |
965 |
$22K |
| D1120 |
Prophylaxis - child |
449 |
418 |
$14K |
| D1208 |
Topical application of fluoride, excluding varnish |
178 |
164 |
$3K |
| D0274 |
Bitewings - four radiographic images |
96 |
84 |
$3K |
| D0191 |
|
23 |
23 |
$494.27 |