NPI: 1790767267 · COUSHATTA, LA 71019 · Dental Clinic/Center · NPI assigned 11/18/2005
Authorized official WILSON, MONTE controls 20+ related entities in our dataset. Read more
| Authorized Official | WILSON, MONTE (CEO) |
| NPI Enumeration Date | 11/18/2005 |
Other providers sharing the same authorized official: WILSON, MONTE
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,631 | $55K |
| 2019 | 2,287 | $86K |
| 2020 | 1,176 | $40K |
| 2021 | 814 | $26K |
| 2022 | 855 | $27K |
| 2023 | 454 | $17K |
| 2024 | 275 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 909 | 897 | $53K |
| D1120 | Prophylaxis - child | 1,315 | 1,306 | $44K |
| D1208 | Topical application of fluoride, excluding varnish | 1,993 | 1,981 | $40K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1,182 | 1,137 | $38K |
| D1110 | Prophylaxis - adult | 745 | 734 | $35K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 244 | 171 | $20K |
| D0120 | Periodic oral evaluation - established patient | 502 | 498 | $13K |
| D0330 | Panoramic radiographic image | 126 | 126 | $7K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 96 | 59 | $6K |
| D0272 | Bitewings - two radiographic images | 268 | 267 | $5K |
| D0140 | Limited oral evaluation - problem focused | 84 | 81 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 28 | 28 | $411.32 |