DECATUR DENTAL SERVICES, INC.
NPI: 1710281860
· BERNE, IN 46711
· Dentist
· NPI assigned 01/04/2011
$123K
Total Medicaid Paid
Provider Details
| Authorized Official | RANLY, ADRIENNE (VICE PRESIDENT) |
| Parent Organization | DECATUR DENTAL SERVICES, INC. |
| NPI Enumeration Date | 01/04/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
119 |
$596.87 |
| 2019 |
216 |
$6K |
| 2020 |
329 |
$10K |
| 2021 |
712 |
$22K |
| 2022 |
1,048 |
$31K |
| 2023 |
839 |
$26K |
| 2024 |
782 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,085 |
1,032 |
$53K |
| D0120 |
Periodic oral evaluation - established patient |
1,671 |
1,570 |
$38K |
| D1208 |
Topical application of fluoride, excluding varnish |
602 |
553 |
$12K |
| D0274 |
Bitewings - four radiographic images |
269 |
253 |
$9K |
| D1120 |
Prophylaxis - child |
204 |
193 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
21 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
149 |
130 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
31 |
28 |
$874.64 |
| D0330 |
Panoramic radiographic image |
13 |
12 |
$787.16 |