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NORTHERN DENTAL GENERAL AND COSMETIC DENTISTRY LLC
NORTHERN DENTAL GENERAL AND COSMETIC DENTISTRY LLC
NPI: 1164877395
· NAPLES, FL 34109
· Dentist
· NPI assigned 04/25/2016
$2.75M
Total Medicaid Paid
Provider Details
| Authorized Official | NOVAK, SHANNON (MANAGER) |
| NPI Enumeration Date | 04/25/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
32 |
$585.90 |
| 2019 |
505 |
$583K |
| 2020 |
1,021 |
$622K |
| 2021 |
415 |
$393K |
| 2022 |
1,877 |
$431K |
| 2023 |
1,556 |
$401K |
| 2024 |
1,543 |
$317K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 21215 |
|
814 |
576 |
$1.42M |
| 21210 |
|
1,278 |
888 |
$1.21M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,736 |
585 |
$52K |
| D0330 |
Panoramic radiographic image |
1,410 |
1,404 |
$45K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
656 |
649 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
767 |
764 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
50 |
12 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
95 |
95 |
$534.72 |
| D1330 |
|
94 |
94 |
$3.00 |
| D4341 |
|
36 |
14 |
$0.00 |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$0.00 |