Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IN › TRAFALGAR › JON A. HENDRICKSON, DDS INC.

JON A. HENDRICKSON, DDS INC.

NPI: 1528228368 · TRAFALGAR, IN 46181 · General Practice Dentistry · NPI assigned 06/16/2008

$16K
Total Medicaid Paid
1,064
Total Claims
1,035
Beneficiaries
6
Codes Billed
2018-01
First Month
2019-08
Last Month

Provider Details

Authorized OfficialHENDRICKSON, JON (OWNER/PRESIDENT)
NPI Enumeration Date06/16/2008

Related Entities

Other providers sharing the same authorized official: HENDRICKSON, JON

ProviderCityStateTotal Paid
PEDIATRIC PARTNERS PA FORT SMITH AR $1.72M
JON HENDRICKSON DDS INC TRAFALGAR IN $1K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 773 $7K
2019 291 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 282 274 $7K
D0120 Periodic oral evaluation - established patient 392 381 $5K
D1208 Topical application of fluoride, excluding varnish 272 264 $2K
D0274 Bitewings - four radiographic images 43 41 $903.76
D1120 Prophylaxis - child 63 63 $759.00
D0272 Bitewings - two radiographic images 12 12 $49.62