NOBLE ORTHODONTICS, LLC
NPI: 1295382992
· BURLINGTON, WI 53105
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 08/19/2019
$911K
Total Medicaid Paid
Provider Details
| Authorized Official | LABLONDE, BRIAN (LLC MEMBERS) |
| NPI Enumeration Date | 08/19/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
622 |
$36K |
| 2022 |
1,528 |
$160K |
| 2023 |
5,910 |
$358K |
| 2024 |
6,117 |
$357K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
4,829 |
4,116 |
$567K |
| D0330 |
Panoramic radiographic image |
1,285 |
1,109 |
$71K |
| D0470 |
|
1,094 |
956 |
$53K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
65 |
51 |
$49K |
| D0340 |
|
1,231 |
1,066 |
$46K |
| D1351 |
Sealant - per tooth |
1,977 |
131 |
$40K |
| D0350 |
|
1,315 |
1,152 |
$35K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
521 |
442 |
$17K |
| D1206 |
Topical application of fluoride varnish |
850 |
736 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
899 |
821 |
$14K |
| D8660 |
|
37 |
37 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
47 |
41 |
$939.40 |
| D9110 |
|
12 |
12 |
$649.66 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
15 |
$423.75 |