FIRST AVENUE DENTAL, P.A.
NPI: 1568138485
· ULYSSES, KS 67880
· General Practice Dentistry
· NPI assigned 08/19/2021
$123K
Total Medicaid Paid
Provider Details
| Authorized Official | LEHMKUHLER, RYAN (PRESIDENT) |
| Parent Organization | FIRST AVENUE DENTAL, P.A. |
| NPI Enumeration Date | 08/19/2021 |
Related Entities
Other providers sharing the same authorized official: LEHMKUHLER, RYAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
3,404 |
$123K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
674 |
672 |
$31K |
| D1206 |
Topical application of fluoride varnish |
1,027 |
1,023 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
836 |
833 |
$26K |
| D0274 |
Bitewings - four radiographic images |
290 |
288 |
$12K |
| D1110 |
Prophylaxis - adult |
209 |
208 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
169 |
167 |
$7K |
| D0272 |
Bitewings - two radiographic images |
152 |
152 |
$5K |
| D0330 |
Panoramic radiographic image |
47 |
47 |
$3K |