ROSSVILLE FAMILY DENTAL, PA
NPI: 1356794549
· ROSSVILLE, KS 66533
· General Practice Dentistry
· NPI assigned 07/22/2016
$141K
Total Medicaid Paid
Provider Details
| Authorized Official | GUEST, SCOTT (COO) |
| NPI Enumeration Date | 07/22/2016 |
Related Entities
Other providers sharing the same authorized official: GUEST, SCOTT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
547 |
$11K |
| 2019 |
397 |
$8K |
| 2020 |
762 |
$18K |
| 2021 |
1,256 |
$29K |
| 2022 |
1,599 |
$36K |
| 2023 |
1,114 |
$26K |
| 2024 |
674 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,452 |
1,395 |
$29K |
| D1110 |
Prophylaxis - adult |
644 |
614 |
$25K |
| D1206 |
Topical application of fluoride varnish |
1,347 |
1,305 |
$23K |
| D1120 |
Prophylaxis - child |
610 |
595 |
$19K |
| D1351 |
Sealant - per tooth |
727 |
139 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
652 |
611 |
$8K |
| D0274 |
Bitewings - four radiographic images |
255 |
241 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
475 |
449 |
$5K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
39 |
13 |
$2K |
| D0330 |
Panoramic radiographic image |
44 |
43 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
61 |
60 |
$2K |
| D0277 |
|
43 |
39 |
$750.00 |