Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › UT › OGDEN › MODERN DENTAL PROFESSIONALS UTAH, PC

MODERN DENTAL PROFESSIONALS UTAH, PC

NPI: 1336404763 · OGDEN, UT 84405 · General Practice Dentistry · NPI assigned 07/11/2012

$8K
Total Medicaid Paid
373
Total Claims
351
Beneficiaries
7
Codes Billed
2018-01
First Month
2020-10
Last Month

Provider Details

Authorized OfficialMARTINEZ, LILIANA (CREDENTIALING DIRECTOR)
NPI Enumeration Date07/11/2012

Related Entities

Other providers sharing the same authorized official: MARTINEZ, LILIANA

ProviderCityStateTotal Paid
MODERN DENTAL PROFESSIONALS UT, PC SOUTH OGDEN UT $22K
MODERN DENTAL PROFESSIONALS - UTAH, PC TAYLORSVILLE UT $7K
MODERN DENTAL PROFESSIONALS - UTAH, PC AMERICAN FORK UT $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 286 $6K
2019 14 $13.98
2020 73 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 126 119 $3K
D0274 Bitewings - four radiographic images 61 57 $2K
D0150 Comprehensive oral evaluation - new or established patient 29 29 $1K
D1206 Topical application of fluoride varnish 16 15 $411.64
D0120 Periodic oral evaluation - established patient 13 12 $393.57
D1120 Prophylaxis - child 33 32 $144.42
D0230 Intraoral - periapical each additional radiographic image 95 87 $0.00