NPI: 1417064890 · DERMOTT, AR 71638 · Dental Clinic/Center · NPI assigned 08/23/2006
Authorized official NICHOLS, GARY controls 20+ related entities in our dataset. Read more
| Authorized Official | NICHOLS, GARY (CEO) |
| NPI Enumeration Date | 08/23/2006 |
Other providers sharing the same authorized official: NICHOLS, GARY
| Provider | City | State | Total Paid |
|---|---|---|---|
| MAINLINE HEALTH SYSTEMS INC | MONTICELLO | AR | $4.81M |
| MAINLINE HEALTH SYSTEMS, INC | STAR CITY | AR | $3.82M |
| MAINLINE HEALTH SYSTEMS INC | WARREN | AR | $2.21M |
| MAINLINE HEALTH SYSTEMS INC | DERMOTT | AR | $1.56M |
| MAINLINE HEALTH SYSTEMS, INC | LAKE VILLAGE | AR | $1.16M |
| MAINLINE HEALTH SYSTEMS, INC. | RISON | AR | $1.04M |
| MAINLINE HEALTH SYSTEMS INC | SHERIDAN | AR | $1.01M |
| MAINLINE HEALTH SYSTEMS, INC | EUDORA | AR | $887K |
| MAINLINE HEALTH SYSTEMS, INC | MONTICELLO | AR | $823K |
| MAINLINE HEALTH SYSTEMS INC | PORTLAND | AR | $598K |
| MAINLINE HEALTH SYSTEMS, INC | STAR CITY | AR | $589K |
| MAINLINE HEALTH SYSTEMS, INC | STAR CITY | AR | $494K |
| MAINLINE HEALTH SYSTEMS INC | WILMOT | AR | $404K |
| MAINLINE HEALTH SYSTEMS, INC | DERMOTT | AR | $288K |
| MAINLINE HEALTH SYSTEMS, INC. | HAMBURG | AR | $211K |
| MAINLINE HEALTH SYSTEMS, INC | WARREN | AR | $159K |
| MAINLINE HEALTH SYSTEMS INC | SHERIDAN | AR | $128K |
| MAINLINE HEALTH SYSTEMS, INC | HAMBURG | AR | $50K |
| MAINLINE HEALTH SYSTEMS, INC | WARREN | AR | $44K |
| MAINLINE HEALTH SYSTEMS, INC. | STAR CITY | AR | $38K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 913 | $22K |
| 2019 | 3,495 | $88K |
| 2020 | 790 | $19K |
| 2021 | 20 | $969.00 |
| 2022 | 995 | $24K |
| 2023 | 970 | $26K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 1,147 | 1,126 | $53K |
| D1208 | Topical application of fluoride, excluding varnish | 1,951 | 1,887 | $37K |
| D0272 | Bitewings - two radiographic images | 1,409 | 1,361 | $33K |
| D1120 | Prophylaxis - child | 650 | 627 | $23K |
| D0120 | Periodic oral evaluation - established patient | 303 | 291 | $8K |
| D0220 | Intraoral - periapical first radiographic image | 449 | 384 | $8K |
| D0274 | Bitewings - four radiographic images | 239 | 238 | $5K |
| D0140 | Limited oral evaluation - problem focused | 144 | 138 | $4K |
| D7140 | Extraction, erupted tooth or exposed root | 27 | 12 | $2K |
| D0603 | 665 | 644 | $2K | |
| D1351 | Sealant - per tooth | 47 | 12 | $1K |
| D0210 | Intraoral - complete series of radiographic images | 15 | 15 | $1K |
| D2140 | 16 | 13 | $1K | |
| D0230 | Intraoral - periapical each additional radiographic image | 35 | 28 | $484.50 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $307.80 |
| D0601 | 48 | 46 | $135.00 | |
| D0602 | 26 | 26 | $130.00 |