NEW PALESTINE FAMILY DENTISTRY, PC
NPI: 1184211856
· NEW PALESTINE, IN 46163
· General Practice Dentistry
· NPI assigned 12/28/2020
$169K
Total Medicaid Paid
Provider Details
| Authorized Official | LEE, VANESSA (PRESIDENT) |
| NPI Enumeration Date | 12/28/2020 |
Related Entities
Other providers sharing the same authorized official: LEE, VANESSA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
594 |
$16K |
| 2022 |
985 |
$31K |
| 2023 |
1,308 |
$40K |
| 2024 |
1,912 |
$82K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,094 |
1,030 |
$55K |
| D0120 |
Periodic oral evaluation - established patient |
1,329 |
1,229 |
$31K |
| D1206 |
Topical application of fluoride varnish |
1,058 |
974 |
$20K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
207 |
129 |
$17K |
| D0274 |
Bitewings - four radiographic images |
378 |
355 |
$13K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
176 |
106 |
$12K |
| D1120 |
Prophylaxis - child |
287 |
264 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
163 |
153 |
$7K |
| D0330 |
Panoramic radiographic image |
31 |
26 |
$2K |
| D1351 |
Sealant - per tooth |
62 |
13 |
$2K |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$367.22 |