FIRST DENTAL GARDEN CITY, LLC
NPI: 1770208621
· GARDEN CITY, KS 67846
· Dental Clinic/Center
· NPI assigned 10/04/2022
$139K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: LEHMKUHLER, RYAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
1,022 |
$38K |
| 2024 |
2,445 |
$102K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
602 |
584 |
$25K |
| D1120 |
Prophylaxis - child |
561 |
551 |
$25K |
| D1206 |
Topical application of fluoride varnish |
779 |
765 |
$20K |
| D0274 |
Bitewings - four radiographic images |
430 |
415 |
$18K |
| D0330 |
Panoramic radiographic image |
226 |
218 |
$17K |
| D1110 |
Prophylaxis - adult |
202 |
199 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
367 |
364 |
$11K |
| D9248 |
|
26 |
24 |
$4K |
| D1351 |
Sealant - per tooth |
74 |
12 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
59 |
53 |
$2K |
| D0272 |
Bitewings - two radiographic images |
53 |
53 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$177.79 |
| D1999 |
|
76 |
68 |
$0.00 |