HAVRE PEDIATRIC DENTISTRY
NPI: 1124626262
· HAVRE, MT 59501
· Pediatric Dentist
· NPI assigned 10/12/2020
$767K
Total Medicaid Paid
Provider Details
| Authorized Official | RENCHER, KEVIN (DENTIST) |
| NPI Enumeration Date | 10/12/2020 |
Related Entities
Other providers sharing the same authorized official: RENCHER, KEVIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
82 |
$2K |
| 2021 |
6,594 |
$162K |
| 2022 |
7,718 |
$199K |
| 2023 |
9,320 |
$206K |
| 2024 |
8,322 |
$197K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
5,805 |
5,220 |
$193K |
| D1206 |
Topical application of fluoride varnish |
7,025 |
6,299 |
$139K |
| D1310 |
|
3,140 |
2,813 |
$114K |
| D0120 |
Periodic oral evaluation - established patient |
4,249 |
3,844 |
$102K |
| D1330 |
|
3,138 |
2,811 |
$67K |
| D0272 |
Bitewings - two radiographic images |
1,660 |
1,474 |
$34K |
| D0603 |
|
3,351 |
3,020 |
$32K |
| D9630 |
|
2,075 |
1,814 |
$29K |
| D0145 |
Oral evaluation for a patient under three years of age |
533 |
493 |
$18K |
| D1320 |
|
502 |
446 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
269 |
253 |
$10K |
| D1110 |
Prophylaxis - adult |
65 |
60 |
$3K |
| D1351 |
Sealant - per tooth |
99 |
12 |
$3K |
| D0425 |
|
68 |
66 |
$3K |
| D0240 |
|
57 |
25 |
$1K |