PALMETTO MOBILE DENTAL CENTERS LLC
NPI: 1588175087
· COLUMBIA, SC 29201
· Dentist
· NPI assigned 10/24/2017
$123K
Total Medicaid Paid
Provider Details
| Authorized Official | NAPPER, MARK (AUTHORIZED OFFICIAL) |
| NPI Enumeration Date | 10/24/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
129 |
$4K |
| 2019 |
2,521 |
$113K |
| 2020 |
194 |
$6K |
| 2021 |
12 |
$236.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,035 |
1,035 |
$42K |
| D7140 |
Extraction, erupted tooth or exposed root |
308 |
101 |
$23K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
188 |
46 |
$21K |
| D1110 |
Prophylaxis - adult |
310 |
310 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
457 |
457 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
126 |
126 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
225 |
225 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
195 |
195 |
$2K |
| D9310 |
|
12 |
12 |
$236.60 |