PEDIATRIC DENTAL GROUP OF LAFAYETTE
NPI: 1326211863
· LAFAYETTE, CO 80026
· Pediatric Dentist
· NPI assigned 04/04/2008
$344K
Total Medicaid Paid
Provider Details
| Authorized Official | HARTSHORN, NICOLE (PRACTICE MANAGER) |
| NPI Enumeration Date | 04/04/2008 |
Related Entities
Other providers sharing the same authorized official: HARTSHORN, NICOLE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
901 |
$21K |
| 2019 |
2,022 |
$50K |
| 2020 |
2,046 |
$53K |
| 2021 |
2,536 |
$64K |
| 2022 |
2,851 |
$75K |
| 2023 |
1,441 |
$38K |
| 2024 |
1,026 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,982 |
2,978 |
$102K |
| D1206 |
Topical application of fluoride varnish |
4,323 |
4,315 |
$86K |
| D0120 |
Periodic oral evaluation - established patient |
3,204 |
3,197 |
$78K |
| D1110 |
Prophylaxis - adult |
707 |
707 |
$33K |
| D0272 |
Bitewings - two radiographic images |
981 |
979 |
$21K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
442 |
442 |
$18K |
| D0330 |
Panoramic radiographic image |
64 |
64 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
64 |
60 |
$2K |
| D0274 |
Bitewings - four radiographic images |
56 |
56 |
$2K |