DENTAL LIFELINE NETWORK COLORADO
NPI: 1396033684
· DENVER, CO 80202
· Voluntary or Charitable Agency
· NPI assigned 07/20/2011
$146K
Total Medicaid Paid
Provider Details
| Authorized Official | BOSWORTH, MELISSA (VICE PRESIDENT AFFILIATE OPERATIONS) |
| Parent Organization | DENTAL LIFELINE NETWORK |
| NPI Enumeration Date | 07/20/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,707 |
$111K |
| 2019 |
445 |
$34K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
1,414 |
1,314 |
$127K |
| D1110 |
Prophylaxis - adult |
178 |
176 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
238 |
236 |
$5K |
| D1206 |
Topical application of fluoride varnish |
227 |
223 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
83 |
81 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$452.64 |