CLARK, TANNER
NPI: 1679841811
· PHILADELPHIA, PA 19146
· General Practice Dentistry
· NPI assigned 12/02/2011
$958K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
336 |
$6K |
| 2019 |
7,286 |
$118K |
| 2020 |
5,128 |
$82K |
| 2021 |
8,157 |
$157K |
| 2022 |
12,083 |
$243K |
| 2023 |
11,977 |
$242K |
| 2024 |
5,073 |
$110K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
5,696 |
5,676 |
$394K |
| D0191 |
|
1,054 |
1,054 |
$174K |
| D0120 |
Periodic oral evaluation - established patient |
4,687 |
4,665 |
$75K |
| D1351 |
Sealant - per tooth |
4,986 |
1,186 |
$74K |
| D0274 |
Bitewings - four radiographic images |
4,145 |
4,132 |
$62K |
| D0230 |
Intraoral - periapical each additional radiographic image |
12,172 |
5,727 |
$45K |
| D1206 |
Topical application of fluoride varnish |
5,716 |
5,701 |
$41K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,141 |
1,138 |
$35K |
| D0220 |
Intraoral - periapical first radiographic image |
5,792 |
5,776 |
$34K |
| D1354 |
|
3,544 |
1,247 |
$16K |
| D0272 |
Bitewings - two radiographic images |
329 |
328 |
$8K |
| D1110 |
Prophylaxis - adult |
15 |
12 |
$851.27 |
| D9995 |
|
748 |
745 |
$267.98 |
| D1330 |
|
15 |
15 |
$0.00 |