FAMILY DENTAL CARE
NPI: 1336287580
· RAPID CITY, SD 57701
· General Practice Dentistry
· NPI assigned 02/01/2007
$174K
Total Medicaid Paid
Provider Details
| Authorized Official | OLSON, JEFFREY (DOCTOR) |
| NPI Enumeration Date | 02/01/2007 |
Related Entities
Other providers sharing the same authorized official: OLSON, JEFFREY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,206 |
$41K |
| 2019 |
1,109 |
$37K |
| 2020 |
461 |
$15K |
| 2021 |
974 |
$34K |
| 2022 |
795 |
$29K |
| 2023 |
263 |
$12K |
| 2024 |
125 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
894 |
893 |
$49K |
| D0120 |
Periodic oral evaluation - established patient |
1,465 |
1,456 |
$43K |
| D1120 |
Prophylaxis - child |
654 |
654 |
$25K |
| D1206 |
Topical application of fluoride varnish |
883 |
883 |
$21K |
| D0274 |
Bitewings - four radiographic images |
473 |
473 |
$17K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
253 |
253 |
$11K |
| D0210 |
Intraoral - complete series of radiographic images |
42 |
42 |
$3K |
| D1351 |
Sealant - per tooth |
100 |
27 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
128 |
124 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
41 |
41 |
$954.48 |