THE DENTAL CLINIC AT STUTTGART
NPI: 1518365048
· STUTTGART, AR 72160
· General Practice Dentistry
· NPI assigned 12/16/2014
Deactivated NPI
· This NPI was deactivated on 01/18/2019. Reactivated 02/06/2019.
$227K
Total Medicaid Paid
Provider Details
| Authorized Official | TANK, PAM (OFFICE MANAGER) |
| NPI Enumeration Date | 12/16/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
544 |
$12K |
| 2021 |
1,953 |
$48K |
| 2022 |
2,106 |
$59K |
| 2023 |
1,937 |
$52K |
| 2024 |
2,237 |
$56K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0240 |
|
2,337 |
1,183 |
$49K |
| D1110 |
Prophylaxis - adult |
939 |
905 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
1,403 |
1,351 |
$34K |
| D0272 |
Bitewings - two radiographic images |
1,354 |
1,309 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,536 |
1,496 |
$29K |
| D1120 |
Prophylaxis - child |
454 |
444 |
$16K |
| D0210 |
Intraoral - complete series of radiographic images |
198 |
191 |
$14K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
136 |
78 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
342 |
287 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
34 |
32 |
$925.60 |
| D0230 |
Intraoral - periapical each additional radiographic image |
30 |
25 |
$323.28 |
| D0601 |
|
14 |
14 |
$65.49 |