1770056426

1770056426 was paid $5.20M by Medicaid between Jul 2019 and Sep 2023, across 37 billing codes. Its largest line is D1354, — 15% of everything it billed.

33Billing provider info1770056426

33aNPI1770056426

33bProvider type—

28Total paid$5.20M

24GClaims145,349

24DCodes billed37

24AFirst – last monthJul 2019 – Sep 2023

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
2019	8,938	$269K
2020	25,884	$839K
2021	31,476	$934K
2022	48,992	$1.93M
2023	30,059	$1.23M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1354		15%	22,610	3,923	$787K
D0330	Panoramic radiographic image	11%	8,123	7,913	$573K
D0140	Limited oral evaluation - problem focused	11%	16,585	14,929	$560K
D7140	Extraction, erupted tooth or exposed root	9.8%	5,747	2,328	$511K
D1110	Prophylaxis - adult	8.5%	8,080	7,851	$442K
D0274	Bitewings - four radiographic images	7.7%	11,076	10,871	$401K
D0220	Intraoral - periapical first radiographic image	4.2%	15,361	14,714	$216K
D0150	Comprehensive oral evaluation - new or established patient	3.7%	5,301	5,120	$193K
D0230	Intraoral - periapical each additional radiographic image	3.7%	19,317	12,321	$193K
D1206	Topical application of fluoride varnish	3.5%	6,883	6,660	$184K
D2150	Silver amalgam - two surfaces, primary or permanent	3.0%	1,706	1,206	$157K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	2.7%	4,323	4,293	$141K

25 more codes

D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	1.9%	911	$97K
D2391	Resin-based composite - one surface, posterior, primary or permanent	1.8%	1,579	$94K
D2140		1.8%	1,372	$92K
D1120	Dental cleaning, child	1.5%	1,994	$80K
D5227		1.4%	29	$74K
D1330		1.4%	9,105	$73K
D4355		1.0%	1,107	$54K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	655	$52K
D9110		<1%	922	$44K
D2330		<1%	664	$42K
D2160		<1%	336	$36K
D2331		<1%	266	$26K
D2332		<1%	172	$19K
D0240		<1%	369	$15K
D5212		<1%	14	$10K
D2335		<1%	88	$9K
D5228		<1%	16	$7K
D5211		<1%	16	$7K
D1351	Sealant - per tooth	<1%	206	$4K
D0272	Bitewings - two radiographic images	<1%	101	$3K
D7111		<1%	14	$1K
D9985		<1%	254	$398.52
D5410		<1%	18	$324.12
D2940		<1%	12	$299.03
D5411		<1%	17	$288.20

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.