NICHOLS PEDIATRIC DENTISTRY PLLC
NPI: 1881099935
· LONGMONT, CO 80501
· Pediatric Dentist
· NPI assigned 10/31/2014
$419K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: NICHOLS, TIMOTHY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
899 |
$20K |
| 2019 |
1,555 |
$44K |
| 2020 |
1,704 |
$44K |
| 2021 |
2,586 |
$65K |
| 2022 |
2,874 |
$72K |
| 2023 |
3,006 |
$76K |
| 2024 |
2,649 |
$98K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
4,130 |
4,125 |
$150K |
| D0120 |
Periodic oral evaluation - established patient |
4,205 |
4,199 |
$106K |
| D1206 |
Topical application of fluoride varnish |
4,905 |
4,899 |
$103K |
| D0272 |
Bitewings - two radiographic images |
1,348 |
1,347 |
$29K |
| D1110 |
Prophylaxis - adult |
236 |
235 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
36 |
12 |
$5K |
| D1351 |
Sealant - per tooth |
111 |
26 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
109 |
105 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
77 |
77 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
92 |
92 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$428.10 |
| D0145 |
Oral evaluation for a patient under three years of age |
12 |
12 |
$383.40 |