CLAYTON DENTAL OFFICES, PLLC
NPI: 1649332180
· CLAYTON, NY 13624
· Durable Medical Equipment & Medical Supplies
· NPI assigned 12/14/2006
$113K
Total Medicaid Paid
3,540
Beneficiary Records
Provider Details
| Authorized Official | LACLAIR, SCOTT (OWNER) |
| NPI Enumeration Date | 12/14/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
15 |
$450.00 |
| 2020 |
269 |
$8K |
| 2021 |
765 |
$27K |
| 2022 |
1,387 |
$44K |
| 2023 |
1,125 |
$33K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
980 |
980 |
$41K |
| D0120 |
Periodic oral evaluation - established patient |
681 |
681 |
$18K |
| D1206 |
Topical application of fluoride varnish |
619 |
619 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
379 |
379 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
80 |
65 |
$10K |
| D0272 |
Bitewings - two radiographic images |
577 |
577 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
158 |
158 |
$2K |
| D1351 |
Sealant - per tooth |
15 |
13 |
$1K |
| D0240 |
|
40 |
39 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
32 |
29 |
$362.67 |