FAMILY DENTAL CARE OF INDIANA LLC
NPI: 1225204084
· ZIONSVILLE, IN 46077
· General Practice Dentistry
· NPI assigned 05/01/2008
$138K
Total Medicaid Paid
Provider Details
| Authorized Official | CARTER, BETH (OWNER) |
| NPI Enumeration Date | 05/01/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
406 |
$3K |
| 2019 |
564 |
$17K |
| 2020 |
726 |
$21K |
| 2021 |
852 |
$25K |
| 2022 |
843 |
$26K |
| 2023 |
896 |
$25K |
| 2024 |
594 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,359 |
1,269 |
$61K |
| D0120 |
Periodic oral evaluation - established patient |
2,081 |
1,931 |
$43K |
| D0274 |
Bitewings - four radiographic images |
566 |
518 |
$18K |
| D1206 |
Topical application of fluoride varnish |
719 |
669 |
$14K |
| D1120 |
Prophylaxis - child |
62 |
59 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
21 |
15 |
$611.80 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18 |
15 |
$177.50 |
| D1208 |
Topical application of fluoride, excluding varnish |
42 |
39 |
$67.17 |
| D1999 |
|
13 |
12 |
$10.00 |