SANTA MARIA, JEAN
NPI: 1699795096
· CRAWFORDSVILLE, IN 47933
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 07/20/2006
$146K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,661 |
$81K |
| 2019 |
2,071 |
$55K |
| 2020 |
411 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
1,811 |
486 |
$48K |
| D1120 |
Prophylaxis - child |
689 |
685 |
$26K |
| D1206 |
Topical application of fluoride varnish |
1,119 |
1,114 |
$25K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
135 |
87 |
$17K |
| D0191 |
|
713 |
713 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
181 |
179 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
237 |
237 |
$6K |
| D0272 |
Bitewings - two radiographic images |
258 |
256 |
$6K |