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SUMMIT DENTAL HEALTH - E STREET LLC
SUMMIT DENTAL HEALTH - E STREET LLC
NPI: 1669880126
· OMAHA, NE 68107
· 1223G0001X
$1.99M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
14,156 |
$306K |
| 2019 |
12,616 |
$270K |
| 2020 |
9,118 |
$212K |
| 2021 |
10,240 |
$226K |
| 2022 |
10,648 |
$403K |
| 2023 |
9,711 |
$460K |
| 2024 |
3,568 |
$110K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
|
2,859 |
1,716 |
$271K |
| D1206 |
|
6,891 |
6,610 |
$199K |
| D7140 |
|
1,760 |
713 |
$186K |
| D0120 |
|
5,402 |
5,392 |
$162K |
| D0210 |
|
2,216 |
2,215 |
$148K |
| D2391 |
|
1,827 |
1,237 |
$146K |
| D1110 |
|
2,808 |
2,801 |
$135K |
| D1351 |
|
4,022 |
864 |
$119K |
| D1120 |
|
3,555 |
3,553 |
$117K |
| D0150 |
|
2,897 |
2,883 |
$98K |
| D0274 |
|
5,270 |
5,249 |
$91K |
| D0220 |
|
9,114 |
8,995 |
$56K |
| D1999 |
|
5,023 |
4,585 |
$50K |
| D0230 |
|
9,529 |
7,995 |
$48K |
| D0140 |
|
1,275 |
1,259 |
$37K |
| D0272 |
|
2,203 |
2,202 |
$31K |
| D0330 |
|
2,907 |
2,893 |
$31K |
| D2393 |
|
188 |
142 |
$22K |
| D2950 |
|
167 |
159 |
$12K |
| D2740 |
|
29 |
26 |
$11K |
| D3330 |
|
27 |
27 |
$9K |
| D7210 |
|
49 |
27 |
$5K |
| D4341 |
|
26 |
12 |
$3K |
| D0145 |
|
13 |
13 |
$444.00 |