JORGENSEN, AMANDA
NPI: 1235158452
· GRIMES, IA 50111
· Dentist
· NPI assigned 07/19/2006
$173K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,194 |
$26K |
| 2019 |
1,084 |
$24K |
| 2020 |
487 |
$13K |
| 2021 |
191 |
$4K |
| 2022 |
679 |
$19K |
| 2023 |
2,056 |
$53K |
| 2024 |
1,401 |
$35K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
2,890 |
223 |
$66K |
| D1110 |
Prophylaxis - adult |
1,267 |
1,232 |
$44K |
| D1206 |
Topical application of fluoride varnish |
1,307 |
1,267 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
677 |
653 |
$16K |
| D0330 |
Panoramic radiographic image |
355 |
348 |
$15K |
| D0274 |
Bitewings - four radiographic images |
444 |
425 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
152 |
148 |
$3K |