JONATHAN GILBART, DDS, PA
NPI: 1316270911
· HAGERSTOWN, MD 21740
· General Practice Dentistry
· NPI assigned 09/14/2009
$117K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: GILBART, JONATHAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
130 |
$3K |
| 2019 |
226 |
$7K |
| 2020 |
37 |
$930.04 |
| 2021 |
291 |
$9K |
| 2022 |
849 |
$30K |
| 2023 |
1,107 |
$37K |
| 2024 |
850 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
1,486 |
1,452 |
$34K |
| D1120 |
Prophylaxis - child |
696 |
677 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
916 |
904 |
$28K |
| D1110 |
Prophylaxis - adult |
161 |
160 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
126 |
119 |
$6K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
29 |
12 |
$4K |
| D0330 |
Panoramic radiographic image |
52 |
46 |
$2K |
| D0274 |
Bitewings - four radiographic images |
24 |
24 |
$577.68 |