JADE DENTAL PROFESSIONALS
NPI: 1902213135
· COLORADO SPRINGS, CO 80903
· General Practice Dentistry
· NPI assigned 07/21/2014
$203K
Total Medicaid Paid
Provider Details
| Authorized Official | RODRIGUEZ, GREG (ADMINSTRATOR) |
| NPI Enumeration Date | 07/21/2014 |
Related Entities
Other providers sharing the same authorized official: RODRIGUEZ, GREG
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
84 |
$4K |
| 2019 |
177 |
$7K |
| 2020 |
244 |
$10K |
| 2021 |
278 |
$12K |
| 2022 |
626 |
$21K |
| 2023 |
950 |
$28K |
| 2024 |
812 |
$123K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2740 |
Crown - porcelain/ceramic |
99 |
30 |
$84K |
| D1110 |
Prophylaxis - adult |
1,022 |
1,016 |
$48K |
| D2950 |
|
101 |
31 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
309 |
309 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
394 |
393 |
$10K |
| D0350 |
|
288 |
282 |
$9K |
| D0274 |
Bitewings - four radiographic images |
245 |
245 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
381 |
373 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
71 |
71 |
$5K |
| D4212 |
|
56 |
13 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
179 |
178 |
$3K |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$649.56 |
| D0180 |
|
14 |
14 |
$600.18 |