KIDS DENTAL PARTNERS, LLC
NPI: 1568883338
· LOS ALAMOS, NM 87544
· Dental Clinic/Center
· NPI assigned 12/22/2013
$144K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: NICHOLS, WILLIAM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,500 |
$97K |
| 2019 |
2,068 |
$47K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,487 |
1,473 |
$46K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,470 |
1,455 |
$26K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
760 |
750 |
$26K |
| D0120 |
Periodic oral evaluation - established patient |
752 |
747 |
$17K |
| D0230 |
Intraoral - periapical each additional radiographic image |
812 |
519 |
$8K |
| D0272 |
Bitewings - two radiographic images |
372 |
371 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
629 |
615 |
$7K |
| D1351 |
Sealant - per tooth |
169 |
54 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
90 |
82 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
27 |
26 |
$792.05 |