5280 PEDIATRIC DENTISTRY
NPI: 1467828905
· LONE TREE, CO 80124
· Pediatric Dentist
· NPI assigned 08/19/2015
$226K
Total Medicaid Paid
Provider Details
| Authorized Official | OWENS, DEREK (OWNER) |
| NPI Enumeration Date | 08/19/2015 |
Related Entities
Other providers sharing the same authorized official: OWENS, DEREK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
375 |
$9K |
| 2019 |
479 |
$12K |
| 2020 |
815 |
$20K |
| 2021 |
1,286 |
$31K |
| 2022 |
1,724 |
$41K |
| 2023 |
1,906 |
$47K |
| 2024 |
1,911 |
$67K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,297 |
2,271 |
$83K |
| D1206 |
Topical application of fluoride varnish |
2,981 |
2,950 |
$62K |
| D0120 |
Periodic oral evaluation - established patient |
2,295 |
2,282 |
$58K |
| D0272 |
Bitewings - two radiographic images |
255 |
251 |
$5K |
| D1110 |
Prophylaxis - adult |
80 |
80 |
$5K |
| D0350 |
|
121 |
121 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
278 |
276 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
51 |
41 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
98 |
97 |
$2K |
| D1351 |
Sealant - per tooth |
40 |
12 |
$1K |