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JESSEN'S FAMILY DENTISTRY AND DENTAL HYGIENE, P.C
JESSEN'S FAMILY DENTISTRY AND DENTAL HYGIENE, P.C
NPI: 1447601976
· ONEILL, NE 68763
· Dentist
· NPI assigned 06/27/2016
$127K
Total Medicaid Paid
Provider Details
| Authorized Official | JESSEN, JON (OWNER) |
| NPI Enumeration Date | 06/27/2016 |
Related Entities
Other providers sharing the same authorized official: JESSEN, JON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
580 |
$12K |
| 2019 |
592 |
$13K |
| 2020 |
767 |
$15K |
| 2021 |
1,151 |
$21K |
| 2022 |
1,728 |
$32K |
| 2023 |
1,108 |
$25K |
| 2024 |
377 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,483 |
1,464 |
$34K |
| D1120 |
Prophylaxis - child |
1,036 |
1,025 |
$28K |
| D1206 |
Topical application of fluoride varnish |
1,006 |
965 |
$24K |
| D1999 |
|
1,383 |
1,294 |
$14K |
| D1110 |
Prophylaxis - adult |
316 |
313 |
$11K |
| D0272 |
Bitewings - two radiographic images |
788 |
774 |
$10K |
| D0274 |
Bitewings - four radiographic images |
199 |
198 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
52 |
52 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$576.32 |
| D0330 |
Panoramic radiographic image |
27 |
27 |
$222.60 |