BROADMOOR VALLEY DENTAL SERVICES, P.C.
NPI: 1740594043
· COLORADO SPRINGS, CO 80906
· General Practice Dentistry
· NPI assigned 07/29/2010
$408K
Total Medicaid Paid
Provider Details
| Authorized Official | SPAETH, OLIVER (PRESIDENT) |
| NPI Enumeration Date | 07/29/2010 |
Related Entities
Other providers sharing the same authorized official: SPAETH, OLIVER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,239 |
$143K |
| 2019 |
2,180 |
$128K |
| 2020 |
691 |
$41K |
| 2021 |
1,318 |
$79K |
| 2022 |
278 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
3,153 |
2,925 |
$299K |
| D0120 |
Periodic oral evaluation - established patient |
1,000 |
985 |
$22K |
| D0230 |
Intraoral - periapical each additional radiographic image |
401 |
396 |
$21K |
| D1110 |
Prophylaxis - adult |
514 |
508 |
$20K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
473 |
460 |
$18K |
| D0210 |
Intraoral - complete series of radiographic images |
144 |
142 |
$11K |
| D1206 |
Topical application of fluoride varnish |
437 |
436 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
547 |
534 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
37 |
12 |
$3K |