DEVEREUX FOUNDATION
NPI: 1609055821
· WEST CHESTER, PA 19380
· Dental Clinic/Center
· NPI assigned 10/25/2007
$243K
Total Medicaid Paid
Provider Details
| Authorized Official | KALBACH, JESSICA (LEAD CONTRACTS ANALYST) |
| NPI Enumeration Date | 10/25/2007 |
Related Entities
Other providers sharing the same authorized official: KALBACH, JESSICA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,631 |
$72K |
| 2019 |
1,671 |
$74K |
| 2020 |
442 |
$19K |
| 2021 |
1,181 |
$46K |
| 2024 |
920 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9920 |
|
1,480 |
1,426 |
$172K |
| D1110 |
Prophylaxis - adult |
895 |
892 |
$29K |
| D0120 |
Periodic oral evaluation - established patient |
1,468 |
1,466 |
$19K |
| D4910 |
|
389 |
389 |
$16K |
| D0274 |
Bitewings - four radiographic images |
117 |
117 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,345 |
1,342 |
$3K |
| D1206 |
Topical application of fluoride varnish |
151 |
151 |
$1K |