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NPI 1689181489
NPI deactivated
1689181489
1689181489 was paid $1.80M by Medicaid between Jan 2018 and Dec 2022, across 31 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 11% of everything it billed.
33Billing provider info1689181489
33aNPI1689181489
33bProvider type—
28Total paid$1.80M
24GClaims54,742
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2022
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 6,671 | $50K | |
| 2019 | 9,647 | $323K | |
| 2020 | 12,102 | $411K | |
| 2021 | 15,792 | $612K | |
| 2022 | 10,530 | $399K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 11% | 7,283 | 6,439 | $197K |
| D1110 | Prophylaxis - adult | 11% | 4,009 | 3,970 | $190K |
| D0330 | Panoramic radiographic image | 11% | 3,082 | 3,056 | $190K |
| D0274 | Bitewings - four radiographic images | 7.3% | 4,260 | 4,235 | $132K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.1% | 2,508 | 1,210 | $127K |
| D3320 | 6.6% | 312 | 268 | $119K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 5.9% | 1,343 | 871 | $106K |
| D1206 | Topical application of fluoride varnish | 4.9% | 3,743 | 3,701 | $88K |
| D0220 | Intraoral - periapical first radiographic image | 4.4% | 6,728 | 6,536 | $79K |
| D2140 | 4.3% | 1,255 | 667 | $78K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.7% | 1,081 | 651 | $66K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.6% | 8,151 | 5,034 | $65K |
19 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 3.6% | 2,112 | $65K |
| D0120 | Dental checkup, returning patient | 3.0% | 2,156 | $54K |
| D2332 | 2.6% | 447 | $46K | |
| D2330 | 2.5% | 737 | $45K | |
| D3310 | 1.7% | 97 | $30K | |
| D2160 | 1.2% | 214 | $21K | |
| D1330 | 1.1% | 3,311 | $21K | |
| D2331 | 1.0% | 211 | $18K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 288 | $14K |
| D1120 | Dental cleaning, child | <1% | 342 | $12K |
| D9110 | <1% | 264 | $11K | |
| D1351 | Sealant - per tooth | <1% | 266 | $7K |
| D2335 | <1% | 56 | $6K | |
| D2161 | <1% | 41 | $5K | |
| D1354 | <1% | 120 | $4K | |
| D4355 | <1% | 63 | $600.80 | |
| D9985 | <1% | 157 | $180.08 | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 0% | 93 | $0.00 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 12 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.