DEWITT DENTAL ASSOCIATES, PC
NPI: 1194870626
· DE WITT, IA 52742
· General Practice Dentistry
· NPI assigned 01/24/2007
$127K
Total Medicaid Paid
Provider Details
| Authorized Official | SIEGEL, KELLY (BUSINESS MANAGER) |
| NPI Enumeration Date | 01/24/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
999 |
$23K |
| 2019 |
979 |
$21K |
| 2020 |
752 |
$15K |
| 2021 |
751 |
$16K |
| 2022 |
861 |
$17K |
| 2023 |
984 |
$21K |
| 2024 |
616 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,540 |
1,492 |
$52K |
| D0120 |
Periodic oral evaluation - established patient |
2,184 |
2,112 |
$36K |
| D1206 |
Topical application of fluoride varnish |
1,262 |
1,230 |
$19K |
| D1120 |
Prophylaxis - child |
299 |
285 |
$7K |
| D0274 |
Bitewings - four radiographic images |
305 |
299 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
352 |
339 |
$5K |