COLORADO MOBILE DENTAL LLC
NPI: 1669917704
· LITTLETON, CO 80122
· Dentist
· NPI assigned 12/28/2016
$359K
Total Medicaid Paid
Provider Details
| Authorized Official | DALY, SALLY (OWNER) |
| NPI Enumeration Date | 12/28/2016 |
Related Entities
Other providers sharing the same authorized official: DALY, SALLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,398 |
$185K |
| 2019 |
756 |
$67K |
| 2020 |
98 |
$9K |
| 2021 |
224 |
$20K |
| 2022 |
165 |
$16K |
| 2023 |
321 |
$31K |
| 2024 |
323 |
$30K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
3,377 |
3,039 |
$319K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
253 |
253 |
$9K |
| D5110 |
|
12 |
12 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
94 |
93 |
$6K |
| D1110 |
Prophylaxis - adult |
100 |
98 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
183 |
178 |
$4K |
| D0350 |
|
86 |
85 |
$3K |
| D1206 |
Topical application of fluoride varnish |
68 |
67 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
23 |
23 |
$987.70 |
| D0220 |
Intraoral - periapical first radiographic image |
49 |
48 |
$584.18 |
| D5410 |
|
14 |
13 |
$552.86 |
| D4346 |
|
12 |
12 |
$504.21 |
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$459.38 |