LANPHARRA DENTISTRY, LLC
NPI: 1841883113
· OMAHA, NE 68117
· Dental Clinic/Center
· NPI assigned 02/17/2021
$117K
Total Medicaid Paid
4,626
Beneficiary Records
Provider Details
| Authorized Official | EDMONDS, JODENE (OFFICE MANAGER) |
| NPI Enumeration Date | 02/17/2021 |
Related Entities
Other providers sharing the same authorized official: EDMONDS, JODENE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
563 |
$13K |
| 2022 |
1,873 |
$43K |
| 2023 |
1,442 |
$40K |
| 2024 |
840 |
$21K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,075 |
1,062 |
$38K |
| D0120 |
Periodic oral evaluation - established patient |
1,452 |
1,441 |
$35K |
| D1206 |
Topical application of fluoride varnish |
753 |
748 |
$19K |
| D0274 |
Bitewings - four radiographic images |
673 |
669 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
142 |
141 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
111 |
111 |
$3K |
| D1120 |
Prophylaxis - child |
96 |
96 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
262 |
256 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
17 |
14 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
18 |
18 |
$814.82 |
| D0330 |
Panoramic radiographic image |
43 |
43 |
$420.02 |
| D0230 |
Intraoral - periapical each additional radiographic image |
76 |
27 |
$404.92 |