Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NE › AINSWORTH › AINSWORTH DENTAL CLINIC LLC

AINSWORTH DENTAL CLINIC LLC

NPI: 1457697153 · AINSWORTH, NE 69210 · General Practice Dentistry · NPI assigned 12/27/2012

$27K
Total Medicaid Paid
1,145
Total Claims
1,102
Beneficiaries
8
Codes Billed
2018-01
First Month
2021-08
Last Month

Provider Details

Authorized OfficialPATTERSON, FRANK (DENTIST)
NPI Enumeration Date12/27/2012

Related Entities

Other providers sharing the same authorized official: PATTERSON, FRANK

ProviderCityStateTotal Paid
PIERRE FAMILY DENTAL PROF LLC PIERRE SD $208K
PATTERSON FAMILY DENTAL PROF LLC WINNER SD $151K
MILLER DENTAL CLINIC PROF LLC MILLER SD $2K
FAMILY SMILES DENTAL PROF LLC RAPID CITY SD $612.60

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 257 $7K
2019 457 $10K
2020 225 $5K
2021 206 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 466 465 $10K
D1206 Topical application of fluoride varnish 384 355 $9K
D1120 Prophylaxis - child 143 143 $4K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 23 12 $2K
D1110 Prophylaxis - adult 41 41 $1K
D0274 Bitewings - four radiographic images 43 43 $807.50
D1999 18 17 $180.00
D0220 Intraoral - periapical first radiographic image 27 26 $150.00