FINGER LAKES DENTAL CARE OF PALMYRA, PLLC
NPI: 1841761103
· PALMYRA, NY 14522
· General Practice Dentistry
· NPI assigned 12/16/2018
$145K
Total Medicaid Paid
Provider Details
| Authorized Official | MORELLO, JENNIFER (DIRECTOR OF FINANCE) |
| NPI Enumeration Date | 12/16/2018 |
Related Entities
Other providers sharing the same authorized official: MORELLO, JENNIFER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
53 |
$2K |
| 2021 |
1,170 |
$36K |
| 2022 |
1,791 |
$53K |
| 2023 |
1,851 |
$54K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
938 |
938 |
$38K |
| D0120 |
Periodic oral evaluation - established patient |
1,300 |
1,300 |
$35K |
| D1110 |
Prophylaxis - adult |
486 |
486 |
$26K |
| D0274 |
Bitewings - four radiographic images |
574 |
574 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,074 |
1,074 |
$14K |
| D1206 |
Topical application of fluoride varnish |
213 |
213 |
$6K |
| D1351 |
Sealant - per tooth |
78 |
25 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
92 |
92 |
$3K |
| D1354 |
|
56 |
12 |
$2K |
| D0330 |
Panoramic radiographic image |
25 |
25 |
$825.55 |
| D0220 |
Intraoral - periapical first radiographic image |
29 |
29 |
$605.82 |