MASTERS FAMILY DENTISTRY LLC
NPI: 1689878415
· GREENWOOD, IN 46142
· Dental Clinic/Center
· NPI assigned 06/14/2007
$101K
Total Medicaid Paid
Provider Details
| Authorized Official | MASTERS, JACOB (MANAGER) |
| NPI Enumeration Date | 06/14/2007 |
Related Entities
Other providers sharing the same authorized official: MASTERS, JACOB
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,302 |
$10K |
| 2019 |
1,734 |
$60K |
| 2020 |
646 |
$20K |
| 2022 |
137 |
$5K |
| 2023 |
208 |
$6K |
| 2024 |
42 |
$799.75 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,019 |
977 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
1,293 |
1,247 |
$20K |
| D0274 |
Bitewings - four radiographic images |
632 |
601 |
$13K |
| D1206 |
Topical application of fluoride varnish |
917 |
869 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
270 |
150 |
$9K |
| D1120 |
Prophylaxis - child |
417 |
402 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
185 |
111 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
195 |
178 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
127 |
127 |
$1K |
| D0330 |
Panoramic radiographic image |
14 |
13 |
$258.08 |