COMMONWEALTH DENTAL CLINIC
NPI: 1144641309
· ROANOKE, VA 24016
· Dental Clinic/Center
· NPI assigned 12/13/2013
$171K
Total Medicaid Paid
Provider Details
| Authorized Official | HARVEY, GREGORY (PRESIDENT) |
| NPI Enumeration Date | 12/13/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
488 |
$9K |
| 2019 |
4,812 |
$108K |
| 2020 |
4,095 |
$29K |
| 2021 |
3,995 |
$24K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
1,953 |
1,898 |
$49K |
| D7140 |
Extraction, erupted tooth or exposed root |
6,718 |
1,989 |
$49K |
| D0140 |
Limited oral evaluation - problem focused |
2,954 |
2,851 |
$41K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,765 |
921 |
$31K |