RIVER VALLEY PRIMARY CARE SERVICES INC
NPI: 1225296619
· RATCLIFF, AR 72951
· Dental Clinic/Center
· NPI assigned 06/02/2008
$208K
Total Medicaid Paid
Provider Details
| Authorized Official | WHITE, JERRY (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 06/02/2008 |
Related Entities
Other providers sharing the same authorized official: WHITE, JERRY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
668 |
$18K |
| 2019 |
276 |
$7K |
| 2020 |
673 |
$17K |
| 2021 |
1,305 |
$35K |
| 2022 |
1,329 |
$40K |
| 2023 |
1,678 |
$49K |
| 2024 |
1,460 |
$42K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,416 |
1,375 |
$63K |
| D0120 |
Periodic oral evaluation - established patient |
2,223 |
2,125 |
$54K |
| D0272 |
Bitewings - two radiographic images |
1,855 |
1,813 |
$41K |
| D1206 |
Topical application of fluoride varnish |
1,268 |
1,234 |
$24K |
| D1120 |
Prophylaxis - child |
481 |
467 |
$16K |
| D7140 |
Extraction, erupted tooth or exposed root |
119 |
38 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
27 |
27 |
$2K |