PEDIATRIC DENTISTRY, P.C.
NPI: 1154750677
· LINCOLN, NE 68516
· Dental Clinic/Center
· NPI assigned 11/05/2013
Deactivated NPI
· This NPI was deactivated on 11/08/2013. Reactivated 12/12/2018.
$536K
Total Medicaid Paid
Provider Details
| Authorized Official | JOHNSON, BRENT (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 11/05/2013 |
Related Entities
Other providers sharing the same authorized official: JOHNSON, BRENT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
3,729 |
$87K |
| 2020 |
2,946 |
$71K |
| 2021 |
4,789 |
$103K |
| 2022 |
4,736 |
$108K |
| 2023 |
3,696 |
$97K |
| 2024 |
2,779 |
$69K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
5,807 |
5,540 |
$145K |
| D0120 |
Periodic oral evaluation - established patient |
5,251 |
5,168 |
$125K |
| D1120 |
Prophylaxis - child |
4,044 |
3,983 |
$113K |
| D1351 |
Sealant - per tooth |
1,556 |
402 |
$41K |
| D1110 |
Prophylaxis - adult |
1,114 |
1,087 |
$40K |
| D1999 |
|
2,954 |
2,829 |
$30K |
| D0272 |
Bitewings - two radiographic images |
1,291 |
1,264 |
$17K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
192 |
126 |
$12K |
| D0274 |
Bitewings - four radiographic images |
233 |
228 |
$5K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
141 |
134 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
36 |
25 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
32 |
32 |
$695.64 |
| D0140 |
Limited oral evaluation - problem focused |
24 |
24 |
$526.13 |