JEFFREY L HENKEN DDS
NPI: 1760592869
· EMMETT, ID 83617
· Dentist
· NPI assigned 08/30/2006
$169K
Total Medicaid Paid
Provider Details
| Authorized Official | HENKEN, JEFFREY (DENTIST OWNER) |
| NPI Enumeration Date | 08/30/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,062 |
$62K |
| 2019 |
1,989 |
$44K |
| 2020 |
1,262 |
$24K |
| 2021 |
1,400 |
$27K |
| 2022 |
504 |
$12K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,518 |
1,516 |
$126K |
| D1120 |
Prophylaxis - child |
283 |
281 |
$23K |
| D1351 |
Sealant - per tooth |
1,643 |
239 |
$13K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
374 |
374 |
$5K |
| D0272 |
Bitewings - two radiographic images |
1,170 |
1,165 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
1,552 |
1,546 |
$520.27 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,592 |
1,588 |
$27.10 |
| D0220 |
Intraoral - periapical first radiographic image |
85 |
83 |
$0.00 |