PRAIRIE ROSE FAMILY DENTISTS
NPI: 1689117830
· BISMARCK, ND 58503
· Dentist
· NPI assigned 11/21/2016
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | SPIES, CHRIS (DOCTOR) |
| NPI Enumeration Date | 11/21/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
970 |
$26K |
| 2019 |
903 |
$26K |
| 2020 |
709 |
$21K |
| 2021 |
669 |
$22K |
| 2022 |
441 |
$14K |
| 2023 |
366 |
$11K |
| 2024 |
259 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,299 |
1,257 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
1,341 |
1,270 |
$37K |
| D1206 |
Topical application of fluoride varnish |
1,329 |
1,279 |
$31K |
| D0272 |
Bitewings - two radiographic images |
145 |
144 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
33 |
15 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
93 |
89 |
$3K |
| D1351 |
Sealant - per tooth |
62 |
12 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$0.00 |