DIMPLES DENTAL SUITE, PC
NPI: 1972046894
· WASHINGTON, DC 20002
· Dentist
· NPI assigned 11/25/2016
$120K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
458 |
$19K |
| 2019 |
726 |
$33K |
| 2020 |
657 |
$29K |
| 2021 |
539 |
$22K |
| 2022 |
329 |
$14K |
| 2023 |
97 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
847 |
836 |
$58K |
| D1208 |
Topical application of fluoride, excluding varnish |
974 |
963 |
$24K |
| D0120 |
Periodic oral evaluation - established patient |
702 |
691 |
$22K |
| D0330 |
Panoramic radiographic image |
81 |
81 |
$6K |
| D0274 |
Bitewings - four radiographic images |
116 |
109 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
27 |
12 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
27 |
27 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
32 |
25 |
$512.00 |