COMFORT DENTAL LLC
NPI: 1861991689
· INDIANAPOLIS, IN 46219
· Dental Clinic/Center
· NPI assigned 02/07/2018
$153K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: CALDWELL, CRATISA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
46 |
$1K |
| 2019 |
377 |
$13K |
| 2020 |
453 |
$15K |
| 2021 |
802 |
$30K |
| 2022 |
1,089 |
$35K |
| 2023 |
939 |
$32K |
| 2024 |
756 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,022 |
964 |
$51K |
| D0140 |
Limited oral evaluation - problem focused |
813 |
735 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
1,128 |
1,081 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
429 |
394 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
494 |
471 |
$10K |
| D0330 |
Panoramic radiographic image |
110 |
107 |
$7K |
| D0274 |
Bitewings - four radiographic images |
91 |
86 |
$3K |
| D1120 |
Prophylaxis - child |
92 |
86 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
37 |
28 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
180 |
158 |
$2K |
| D0272 |
Bitewings - two radiographic images |
66 |
58 |
$1K |