OSWEGO DENTAL ASSOCIATES
NPI: 1649293663
· LAKE OSWEGO, OR 97035
· General Practice Dentistry
· NPI assigned 07/25/2006
$786.00
Total Medicaid Paid
Provider Details
| Authorized Official | PARSON, CARRIE (OFFICE MANAGER) |
| NPI Enumeration Date | 07/25/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
26 |
$94.00 |
| 2019 |
411 |
$616.00 |
| 2020 |
66 |
$76.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
93 |
93 |
$266.00 |
| D0220 |
Intraoral - periapical first radiographic image |
183 |
181 |
$221.00 |
| D1110 |
Prophylaxis - adult |
38 |
38 |
$188.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
75 |
75 |
$54.00 |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$29.00 |
| D0120 |
Periodic oral evaluation - established patient |
60 |
60 |
$28.00 |
| D1120 |
Prophylaxis - child |
27 |
27 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |