1720016736

1720016736 was paid $687K by Medicaid between Jan 2018 and Apr 2022, across 8 billing codes. Its largest line is D8670, Periodic orthodontic treatment visit — 84% of everything it billed.

33Billing provider info1720016736

33aNPI1720016736

33bProvider type—

28Total paid$687K

24GClaims7,027

24DCodes billed8

24AFirst – last monthJan 2018 – Apr 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	2,001	$161K
2019	2,180	$241K
2020	1,273	$124K
2021	1,347	$141K
2022	226	$21K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D8670	Periodic orthodontic treatment visit	84%	6,065	5,903	$576K
D8080	Comprehensive orthodontic treatment of the adolescent dentition	7.2%	59	57	$49K
D8680		2.5%	29	27	$17K
D0150	Comprehensive oral evaluation - new or established patient	1.6%	271	260	$11K
D8070		1.6%	119	106	$11K
D0330	Panoramic radiographic image	1.2%	157	145	$8K
D0340		1.1%	156	145	$8K
D0470		<1%	171	156	$7K

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.