SPRINGFIELD KIDS DENTIST LLC
NPI: 1831603018
· SPRINGFIELD, OR 97478
· Pediatric Dentist
· NPI assigned 11/26/2017
$2.52M
Total Medicaid Paid
Provider Details
| Authorized Official | BEDOLLA, FEMINA (OPERATIONS OFFICER) |
| NPI Enumeration Date | 11/26/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
33,756 |
$725K |
| 2020 |
32,025 |
$727K |
| 2021 |
36,239 |
$285K |
| 2022 |
38,886 |
$275K |
| 2023 |
37,901 |
$304K |
| 2024 |
22,766 |
$203K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
19,954 |
19,434 |
$456K |
| D2930 |
|
6,033 |
1,787 |
$297K |
| D0120 |
|
15,614 |
15,255 |
$282K |
| D1206 |
|
20,042 |
19,516 |
$207K |
| D2391 |
|
3,510 |
1,988 |
$140K |
| D2392 |
|
2,816 |
1,772 |
$133K |
| D1351 |
|
7,695 |
2,523 |
$127K |
| D0272 |
|
10,602 |
10,331 |
$117K |
| D7140 |
|
2,083 |
1,144 |
$93K |
| D0150 |
|
3,950 |
3,852 |
$86K |
| D1354 |
|
12,704 |
3,328 |
$86K |
| D0603 |
|
16,829 |
16,474 |
$65K |
| D0140 |
|
3,084 |
2,933 |
$58K |
| D9230 |
|
3,772 |
3,545 |
$57K |
| D0240 |
|
6,317 |
3,329 |
$54K |
| D0330 |
|
1,782 |
1,751 |
$48K |
| D1110 |
|
1,063 |
1,047 |
$44K |
| D0220 |
|
4,995 |
4,805 |
$33K |
| D8660 |
|
243 |
230 |
$31K |
| D0230 |
|
5,092 |
2,227 |
$22K |
| D2929 |
|
94 |
17 |
$21K |
| D9420 |
|
125 |
125 |
$18K |
| D3220 |
|
203 |
141 |
$14K |
| D0274 |
|
405 |
395 |
$9K |
| D0601 |
|
2,103 |
1,997 |
$7K |
| D0602 |
|
1,360 |
1,302 |
$4K |
| D2330 |
|
89 |
55 |
$4K |
| D9920 |
|
5,567 |
5,366 |
$3K |
| D1999 |
|
500 |
467 |
$1K |
| D0145 |
|
556 |
535 |
$758.47 |
| D0270 |
|
68 |
67 |
$686.70 |
| D1320 |
|
757 |
749 |
$220.00 |
| D1330 |
|
20,270 |
19,791 |
$150.00 |
| D1310 |
|
20,199 |
19,720 |
$150.00 |
| D1510 |
|
15 |
12 |
$0.00 |
| D9986 |
|
706 |
679 |
$0.00 |
| D9971 |
|
92 |
44 |
$0.00 |
| D0470 |
|
243 |
230 |
$0.00 |
| D3120 |
|
21 |
13 |
$0.00 |
| D9995 |
|
20 |
19 |
$0.00 |