OLIVE BRANCH DENTAL-2 LLC
NPI: 1972264398
· COLUMBUS, IN 47201
· General Practice Dentistry
· NPI assigned 01/07/2022
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
15 |
$649.65 |
| 2023 |
601 |
$12K |
| 2024 |
180 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
210 |
196 |
$9K |
| D0274 |
Bitewings - four radiographic images |
87 |
81 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
254 |
117 |
$2K |
| D1110 |
Prophylaxis - adult |
33 |
33 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
150 |
138 |
$2K |
| D0330 |
Panoramic radiographic image |
34 |
32 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$411.60 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$291.28 |