JACKSON, CHARLES
NPI: 1982769840
· JACKSON HEIGHTS, NY 11372
· General Practice Dentistry
· NPI assigned 12/22/2006
$299K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,005 |
$153K |
| 2019 |
4,142 |
$133K |
| 2020 |
467 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,870 |
1,849 |
$82K |
| D9920 |
|
2,414 |
2,346 |
$69K |
| D0120 |
Periodic oral evaluation - established patient |
2,190 |
2,165 |
$52K |
| D9243 |
|
164 |
161 |
$40K |
| D1206 |
Topical application of fluoride varnish |
1,047 |
1,034 |
$31K |
| D7140 |
Extraction, erupted tooth or exposed root |
209 |
132 |
$10K |
| D0272 |
Bitewings - two radiographic images |
545 |
533 |
$7K |
| D9239 |
|
61 |
61 |
$5K |
| D0330 |
Panoramic radiographic image |
90 |
90 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
24 |
$176.00 |