APPLEWHITE DENTAL IOWA PC
NPI: 1225698046
· MANCHESTER, IA 52057
· Dentist
· NPI assigned 06/14/2019
$173K
Total Medicaid Paid
Provider Details
| Authorized Official | LOSO, SHARON (CREDENTIALING SPECIALIST) |
| Parent Organization | APPLEWHITE DENTAL IOWA PC |
| NPI Enumeration Date | 06/14/2019 |
Related Entities
Other providers sharing the same authorized official: LOSO, SHARON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
14 |
$438.72 |
| 2021 |
1,540 |
$34K |
| 2022 |
2,194 |
$46K |
| 2023 |
2,206 |
$52K |
| 2024 |
1,705 |
$40K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,207 |
1,193 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
2,271 |
2,251 |
$40K |
| D1206 |
Topical application of fluoride varnish |
2,380 |
2,360 |
$38K |
| D1120 |
Prophylaxis - child |
1,044 |
1,038 |
$28K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
218 |
126 |
$15K |
| D0274 |
Bitewings - four radiographic images |
294 |
293 |
$7K |
| D0272 |
Bitewings - two radiographic images |
185 |
184 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
45 |
39 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
14 |
$135.00 |