RUSSELLVILLE FAMILY DENTISTRY PA
NPI: 1508287251
· RUSSELLVILLE, AR 72801
· General Practice Dentistry
· NPI assigned 12/25/2013
$188K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
40 |
$931.00 |
| 2021 |
1,440 |
$49K |
| 2022 |
1,504 |
$50K |
| 2023 |
1,443 |
$46K |
| 2024 |
1,208 |
$42K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,007 |
987 |
$46K |
| D0120 |
Periodic oral evaluation - established patient |
1,342 |
1,308 |
$34K |
| D2140 |
|
426 |
239 |
$27K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,306 |
1,275 |
$25K |
| D0272 |
Bitewings - two radiographic images |
837 |
830 |
$20K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
169 |
98 |
$13K |
| D0210 |
Intraoral - complete series of radiographic images |
180 |
147 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
316 |
308 |
$10K |
| D2160 |
|
18 |
12 |
$2K |
| D1120 |
Prophylaxis - child |
20 |
20 |
$692.00 |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$564.30 |