NISHNA VALLEY DENTAL
NPI: 1336634799
· ATLANTIC, IA 50022
· Dental Clinic/Center
· NPI assigned 06/28/2018
$143K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: SCHROEDER, TAYLOR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
194 |
$3K |
| 2019 |
465 |
$8K |
| 2020 |
504 |
$8K |
| 2021 |
243 |
$4K |
| 2022 |
1,171 |
$29K |
| 2023 |
1,916 |
$51K |
| 2024 |
1,368 |
$39K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,233 |
1,225 |
$50K |
| D0120 |
Periodic oral evaluation - established patient |
2,146 |
2,117 |
$41K |
| D1206 |
Topical application of fluoride varnish |
1,447 |
1,428 |
$24K |
| D1120 |
Prophylaxis - child |
481 |
472 |
$13K |
| D0274 |
Bitewings - four radiographic images |
461 |
457 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
53 |
53 |
$583.34 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$547.07 |
| D0272 |
Bitewings - two radiographic images |
13 |
13 |
$212.81 |
| D1999 |
|
15 |
12 |
$0.00 |