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SUMMIT DENTAL HEALTH - OLD MARKET LLC
SUMMIT DENTAL HEALTH - OLD MARKET LLC
NPI: 1235547050
· OMAHA, NE 68102
· 1223G0001X
$543K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
862 |
$14K |
| 2019 |
2,555 |
$49K |
| 2020 |
2,490 |
$49K |
| 2021 |
4,568 |
$106K |
| 2022 |
2,635 |
$111K |
| 2023 |
3,408 |
$151K |
| 2024 |
1,551 |
$64K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
|
2,109 |
2,071 |
$101K |
| D0210 |
|
1,352 |
1,328 |
$88K |
| D2392 |
|
700 |
431 |
$69K |
| D0150 |
|
2,005 |
1,960 |
$68K |
| D1206 |
|
2,293 |
2,222 |
$59K |
| D0120 |
|
1,155 |
1,142 |
$34K |
| D0274 |
|
2,546 |
2,496 |
$31K |
| D0330 |
|
2,106 |
2,056 |
$20K |
| D0140 |
|
474 |
469 |
$17K |
| D0220 |
|
1,842 |
1,750 |
$14K |
| D2391 |
|
159 |
94 |
$12K |
| D7140 |
|
131 |
53 |
$10K |
| D1351 |
|
369 |
75 |
$8K |
| D7210 |
|
33 |
12 |
$4K |
| D0230 |
|
625 |
242 |
$4K |
| D1120 |
|
102 |
99 |
$3K |
| D2393 |
|
17 |
12 |
$1K |
| D1999 |
|
51 |
49 |
$510.00 |