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HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
NPI: 1174996359
· PORTSMOUTH, VA 23704
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 11/10/2015
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | DAVIS, GRACE (BUSINESS ADMINISTRATOR) |
| Parent Organization | HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC |
| NPI Enumeration Date | 11/10/2015 |
Related Entities
Other providers sharing the same authorized official: DAVIS, GRACE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
863 |
$20K |
| 2020 |
892 |
$22K |
| 2021 |
854 |
$21K |
| 2022 |
1,060 |
$25K |
| 2023 |
1,056 |
$20K |
| 2024 |
702 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,646 |
1,549 |
$42K |
| D1120 |
Prophylaxis - child |
981 |
922 |
$26K |
| D1206 |
Topical application of fluoride varnish |
1,397 |
1,314 |
$22K |
| D1110 |
Prophylaxis - adult |
388 |
350 |
$13K |
| D0272 |
Bitewings - two radiographic images |
537 |
495 |
$9K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
126 |
120 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
182 |
175 |
$3K |
| D0240 |
|
106 |
81 |
$3K |
| D1351 |
Sealant - per tooth |
49 |
13 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
14 |
$653.10 |