FAIRVIEW FAMILY DENTAL LLC
NPI: 1184229809
· GREENWOOD, IN 46142
· Dental Clinic/Center
· NPI assigned 12/01/2020
$155K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: TRAGER, STEPHEN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
76 |
$4K |
| 2022 |
1,113 |
$42K |
| 2023 |
1,524 |
$57K |
| 2024 |
1,335 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
881 |
800 |
$44K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
621 |
533 |
$23K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
259 |
141 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
767 |
718 |
$19K |
| D0210 |
Intraoral - complete series of radiographic images |
368 |
338 |
$16K |
| D1206 |
Topical application of fluoride varnish |
443 |
405 |
$9K |
| D0274 |
Bitewings - four radiographic images |
273 |
239 |
$9K |
| D0330 |
Panoramic radiographic image |
232 |
202 |
$8K |
| D1120 |
Prophylaxis - child |
204 |
197 |
$6K |