REBECCA P. BOLON DDS MSD PC
NPI: 1699491316
· INDIANAPOLIS, IN 46260
· Dental Clinic/Center
· NPI assigned 10/14/2022
$258K
Total Medicaid Paid
Provider Details
| Authorized Official | PADRICK, DAVID (OFFICE MANAGER) |
| NPI Enumeration Date | 10/14/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
48 |
$43K |
| 2024 |
281 |
$214K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
84 |
76 |
$250K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
123 |
122 |
$5K |
| D0330 |
Panoramic radiographic image |
122 |
121 |
$3K |