LECHTENBERG DENTAL CLINIC
NPI: 1376700898
· MAQUOKETA, IA 52060
· Dentist
· NPI assigned 05/21/2008
$139K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
637 |
$12K |
| 2019 |
805 |
$16K |
| 2020 |
796 |
$15K |
| 2021 |
1,205 |
$24K |
| 2022 |
1,523 |
$28K |
| 2023 |
1,665 |
$33K |
| 2024 |
458 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,190 |
2,151 |
$40K |
| D1206 |
Topical application of fluoride varnish |
2,185 |
2,145 |
$35K |
| D1110 |
Prophylaxis - adult |
880 |
862 |
$32K |
| D1120 |
Prophylaxis - child |
479 |
468 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
577 |
552 |
$6K |
| D0274 |
Bitewings - four radiographic images |
189 |
186 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
520 |
284 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
28 |
18 |
$2K |
| D4910 |
|
12 |
12 |
$704.19 |
| D0272 |
Bitewings - two radiographic images |
29 |
29 |
$482.72 |