PREMIER CHOICE DENTAL PLLC
NPI: 1366099517
· BELGRADE, MT 59714
· General Practice Dentistry
· NPI assigned 08/22/2019
$133K
Total Medicaid Paid
Provider Details
| Authorized Official | BENNION, JOHN (MANAGER) |
| NPI Enumeration Date | 08/22/2019 |
Related Entities
Other providers sharing the same authorized official: BENNION, JOHN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
438 |
$39K |
| 2021 |
815 |
$91K |
| 2022 |
12 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0367 |
|
258 |
255 |
$71K |
| D9243 |
|
51 |
50 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
277 |
274 |
$10K |
| D2740 |
Crown - porcelain/ceramic |
13 |
12 |
$8K |
| D0274 |
Bitewings - four radiographic images |
204 |
202 |
$7K |
| D9239 |
|
62 |
62 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
87 |
14 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
39 |
25 |
$4K |
| D1110 |
Prophylaxis - adult |
82 |
82 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
110 |
108 |
$4K |
| D5850 |
|
19 |
16 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
23 |
12 |
$2K |
| D2950 |
|
13 |
12 |
$1K |
| D1206 |
Topical application of fluoride varnish |
15 |
14 |
$310.17 |
| D1330 |
|
12 |
12 |
$0.00 |