IMLAY CITY DENTAL, P.L.L.C.
NPI: 1740233915
· IMLAY CITY, MI 48444
· General Practice Dentistry
· NPI assigned 05/18/2006
$134K
Total Medicaid Paid
Provider Details
| Authorized Official | NICHOLS, HENRY (DENTIST) |
| NPI Enumeration Date | 05/18/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,194 |
$34K |
| 2019 |
970 |
$24K |
| 2020 |
906 |
$22K |
| 2021 |
1,218 |
$29K |
| 2022 |
1,040 |
$25K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
984 |
984 |
$35K |
| D0120 |
Periodic oral evaluation - established patient |
1,389 |
1,389 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,199 |
1,199 |
$26K |
| D1110 |
Prophylaxis - adult |
476 |
476 |
$22K |
| D0220 |
Intraoral - periapical first radiographic image |
621 |
618 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
513 |
497 |
$4K |
| D0274 |
Bitewings - four radiographic images |
116 |
116 |
$3K |
| D0272 |
Bitewings - two radiographic images |
30 |
30 |
$559.46 |