MODERN DENTAL PROFESSIONALS CO PC
NPI: 1376924753
· AURORA, CO 80016
· General Practice Dentistry
· NPI assigned 06/11/2015
$125K
Total Medicaid Paid
Provider Details
| Authorized Official | MONTENEGRO, ARACELLY (SR. MANAGER PAYER SOLUTIONS GROUP) |
| Parent Organization | MODERN DENTAL PROFESSIONALS CO PC |
| NPI Enumeration Date | 06/11/2015 |
Related Entities
Other providers sharing the same authorized official: MONTENEGRO, ARACELLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
299 |
$11K |
| 2019 |
144 |
$4K |
| 2020 |
354 |
$15K |
| 2021 |
560 |
$30K |
| 2022 |
260 |
$9K |
| 2023 |
225 |
$8K |
| 2024 |
227 |
$48K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2740 |
Crown - porcelain/ceramic |
35 |
17 |
$32K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
473 |
464 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
592 |
587 |
$14K |
| D0330 |
Panoramic radiographic image |
251 |
244 |
$13K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
94 |
55 |
$13K |
| D1110 |
Prophylaxis - adult |
275 |
275 |
$12K |
| D2950 |
|
62 |
31 |
$8K |
| D4342 |
|
67 |
25 |
$6K |
| D4910 |
|
40 |
40 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
27 |
27 |
$2K |
| D1206 |
Topical application of fluoride varnish |
57 |
57 |
$1K |
| D0274 |
Bitewings - four radiographic images |
33 |
33 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
25 |
25 |
$829.60 |
| D0220 |
Intraoral - periapical first radiographic image |
38 |
38 |
$471.06 |