FAIRWOOD DENTAL LLC
NPI: 1639799471
· RENTON, WA 98058
· General Practice Dentistry
· NPI assigned 04/22/2020
$1.20M
Total Medicaid Paid
Provider Details
| Authorized Official | PROBST, TRAVIS (OWNER) |
| NPI Enumeration Date | 04/22/2020 |
Related Entities
Other providers sharing the same authorized official: PROBST, TRAVIS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
4,097 |
$87K |
| 2021 |
6,681 |
$193K |
| 2022 |
5,371 |
$254K |
| 2023 |
8,343 |
$377K |
| 2024 |
7,868 |
$292K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
|
4,699 |
1,876 |
$324K |
| D2393 |
|
2,120 |
1,108 |
$212K |
| D0150 |
|
3,309 |
2,958 |
$120K |
| D0210 |
|
3,046 |
2,723 |
$120K |
| D1110 |
|
2,080 |
1,874 |
$100K |
| D2391 |
|
1,234 |
587 |
$61K |
| D0140 |
|
1,753 |
1,580 |
$51K |
| D1206 |
|
2,253 |
2,019 |
$45K |
| D4341 |
|
892 |
344 |
$33K |
| D0220 |
|
3,262 |
2,794 |
$31K |
| D0120 |
|
730 |
646 |
$23K |
| D7140 |
|
479 |
141 |
$18K |
| D0274 |
|
1,013 |
926 |
$14K |
| D7210 |
|
142 |
66 |
$13K |
| D2394 |
|
93 |
58 |
$10K |
| D1999 |
|
1,357 |
955 |
$9K |
| D0230 |
|
3,132 |
1,466 |
$7K |
| D1208 |
|
466 |
419 |
$5K |
| D2331 |
|
42 |
24 |
$4K |
| D1351 |
|
214 |
39 |
$3K |
| D2330 |
|
32 |
14 |
$1K |
| D1120 |
|
12 |
12 |
$275.76 |