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NPI 1346448115
NPI deactivated
1346448115
1346448115 was paid $2.02M by Medicaid between Jan 2018 and Oct 2021, across 24 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 18% of everything it billed.
33Billing provider info1346448115
33aNPI1346448115
33bProvider type—
28Total paid$2.02M
24GClaims58,508
24DCodes billed24
24AFirst – last monthJan 2018 – Oct 2021
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 19,392 | $728K | |
| 2019 | 21,036 | $706K | |
| 2020 | 8,040 | $263K | |
| 2021 | 10,040 | $325K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 18% | 3,703 | 646 | $363K |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 6,519 | 6,203 | $207K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 8.2% | 2,198 | 987 | $166K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.4% | 2,236 | 1,140 | $150K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.1% | 6,368 | 6,029 | $144K |
| D7140 | Extraction, erupted tooth or exposed root | 6.6% | 2,514 | 726 | $133K |
| D1110 | Prophylaxis - adult | 5.3% | 2,702 | 2,522 | $107K |
| D1208 | Topical application of fluoride, excluding varnish | 5.2% | 5,485 | 5,175 | $104K |
| D0274 | Bitewings - four radiographic images | 4.5% | 3,839 | 3,616 | $92K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.5% | 1,262 | 440 | $90K |
| D0330 | Panoramic radiographic image | 4.4% | 2,479 | 2,347 | $90K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.2% | 2,359 | 1,883 | $64K |
12 more codes
| D1206 | Topical application of fluoride varnish | 3.1% | 3,214 | $63K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.8% | 992 | $57K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.2% | 5,570 | $44K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.1% | 1,592 | $43K |
| D2394 | 1.5% | 364 | $31K | |
| D0220 | Intraoral - periapical first radiographic image | 1.4% | 2,580 | $28K |
| D0272 | Bitewings - two radiographic images | 1.2% | 1,473 | $24K |
| D0140 | Limited oral evaluation - problem focused | <1% | 861 | $19K |
| D1351 | Sealant - per tooth | <1% | 96 | $3K |
| D2920 | <1% | 15 | $614.32 | |
| D1999 | 0% | 22 | $0.00 | |
| D9999 | Unspecified adjunctive procedure, by report | 0% | 65 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.