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NPI 1629710009
NPI deactivated
1629710009
1629710009 was paid $755K by Medicaid between Jan 2023 and Oct 2024, across 11 billing codes. Its largest line is D8080, Comprehensive orthodontic treatment of the adolescent dentition — 44% of everything it billed.
33Billing provider info1629710009
33aNPI1629710009
33bProvider type—
28Total paid$755K
24GClaims5,377
24DCodes billed11
24AFirst – last monthJan 2023 – Oct 2024
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 3,615 | $573K | |
| 2024incomplete | 1,762 | $182K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D8080 | Comprehensive orthodontic treatment of the adolescent dentition | 44% | 129 | 129 | $332K |
| D8660 | 16% | 828 | 805 | $121K | |
| D8670 | Periodic orthodontic treatment visit | 12% | 652 | 648 | $87K |
| D0340 | 6.6% | 817 | 794 | $50K | |
| D0330 | Panoramic radiographic image | 5.3% | 737 | 716 | $40K |
| D0470 | 5.0% | 759 | 738 | $38K | |
| D0350 | 4.1% | 933 | 909 | $31K | |
| D0160 | 3.9% | 399 | 398 | $30K | |
| D8680 | 3.0% | 96 | 96 | $23K | |
| D8999 | <1% | 13 | 13 | $2K | |
| D8704 | <1% | 14 | 14 | $2K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.