SANDSTONE FAMILY DENTISTRY, P.C.
NPI: 1508136755
· POTSDAM, NY 13676
· Dentist
· NPI assigned 01/05/2012
$224K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
561 |
$20K |
| 2019 |
806 |
$28K |
| 2020 |
903 |
$29K |
| 2021 |
1,228 |
$40K |
| 2022 |
1,291 |
$43K |
| 2023 |
1,043 |
$36K |
| 2024 |
808 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,682 |
1,682 |
$92K |
| D0120 |
Periodic oral evaluation - established patient |
2,555 |
2,555 |
$70K |
| D1120 |
Prophylaxis - child |
749 |
749 |
$32K |
| D0274 |
Bitewings - four radiographic images |
576 |
576 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,048 |
1,048 |
$15K |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$239.70 |
| D1999 |
|
15 |
15 |
$0.00 |