STATE OF DELAWARE
NPI: 1780756551
· DOVER, DE 19901
· Dental Clinic/Center
· NPI assigned 11/15/2006
$143K
Total Medicaid Paid
Provider Details
| Authorized Official | CONTE, NICHOLAS (DENTAL DIRECTOR) |
| NPI Enumeration Date | 11/15/2006 |
Related Entities
Other providers sharing the same authorized official: CONTE, NICHOLAS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,805 |
$105K |
| 2019 |
972 |
$38K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
675 |
672 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
293 |
291 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
418 |
415 |
$17K |
| D1206 |
Topical application of fluoride varnish |
461 |
458 |
$15K |
| D0272 |
Bitewings - two radiographic images |
366 |
364 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
356 |
355 |
$11K |
| D0330 |
Panoramic radiographic image |
100 |
100 |
$8K |
| D1351 |
Sealant - per tooth |
155 |
53 |
$8K |
| D0274 |
Bitewings - four radiographic images |
108 |
108 |
$5K |
| D1110 |
Prophylaxis - adult |
73 |
73 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
15 |
13 |
$3K |
| D0240 |
|
23 |
12 |
$450.84 |
| D0602 |
|
380 |
379 |
$0.00 |
| D0603 |
|
273 |
272 |
$0.00 |
| D0601 |
|
81 |
81 |
$0.00 |