SADDLE ROCK PEDIATRIC DENTISTRY, P.C.

NPI: 1861652596 · AURORA, CO 80016 · Pediatric Dentist · NPI assigned 06/16/2008

$98K

Total Medicaid Paid

4,297

Total Claims

4,293

Beneficiaries

Codes Billed

2018-01

First Month

2019-05

Last Month

Provider Details

Authorized Official	FOSTER, KAREN (PRESIDENT)
NPI Enumeration Date	06/16/2008

Other providers sharing the same authorized official: FOSTER, KAREN

Provider	City	State	Total Paid
AGAPE HEALTH CENTER	SCOTTSVILLE	KY	$169K
PALMETTO BILL RITE	MURRELLS INLET	SC	$30K

Year	Claims	Total Paid
2018	2,497	$57K
2019	1,800	$41K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	1,035	1,035	$31K
D0120	Periodic oral evaluation - established patient	1,119	1,119	$24K
D1206	Topical application of fluoride varnish	1,286	1,286	$21K
D1110	Prophylaxis - adult	208	208	$8K
D0272	Bitewings - two radiographic images	277	277	$5K
D0230	Intraoral - periapical each additional radiographic image	114	113	$3K
D0220	Intraoral - periapical first radiographic image	205	204	$2K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	53	51	$2K