BONNESS DENTISTY
NPI: 1346699857
· TERRE HAUTE, IN 47807
· Dentist
· NPI assigned 06/06/2016
$127K
Total Medicaid Paid
Provider Details
| Authorized Official | BONNESS, RICHARD (DENTIST/OWNER) |
| NPI Enumeration Date | 06/06/2016 |
Related Entities
Other providers sharing the same authorized official: BONNESS, RICHARD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
309 |
$1K |
| 2019 |
627 |
$21K |
| 2020 |
627 |
$23K |
| 2021 |
722 |
$26K |
| 2022 |
646 |
$23K |
| 2023 |
560 |
$21K |
| 2024 |
306 |
$12K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,384 |
1,312 |
$66K |
| D0120 |
Periodic oral evaluation - established patient |
1,752 |
1,653 |
$38K |
| D0274 |
Bitewings - four radiographic images |
540 |
511 |
$19K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
47 |
25 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
19 |
19 |
$812.95 |
| D1206 |
Topical application of fluoride varnish |
28 |
24 |
$496.18 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$379.50 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
15 |
$237.24 |