SPARK ORTHODONTICS
NPI: 1841997871
· PHILADELPHIA, PA 19134
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 02/09/2023
$1.34M
Total Medicaid Paid
Provider Details
| Authorized Official | LE, PHI (CREDENTIALING MANAGER) |
| NPI Enumeration Date | 02/09/2023 |
Related Entities
Other providers sharing the same authorized official: LE, PHI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
400 |
$106K |
| 2024 |
5,837 |
$1.23M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
3,057 |
2,844 |
$981K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
234 |
232 |
$245K |
| D8660 |
|
1,199 |
1,163 |
$64K |
| D1206 |
Topical application of fluoride varnish |
564 |
561 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
507 |
504 |
$12K |
| D1120 |
Prophylaxis - child |
300 |
299 |
$11K |
| D8680 |
|
44 |
44 |
$6K |
| D1330 |
|
288 |
288 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
16 |
16 |
$880.00 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$495.00 |
| D0272 |
Bitewings - two radiographic images |
16 |
16 |
$220.00 |