MONUMENT CHILD DENTAL & ORTHODONTIC SPECIALISTS PC
NPI: 1992063176
· COLORADO SPRINGS, CO 80921
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 04/25/2012
$259K
Total Medicaid Paid
Provider Details
| Authorized Official | RUSH, DAWN (BUSINESS MANAGER) |
| NPI Enumeration Date | 04/25/2012 |
Related Entities
Other providers sharing the same authorized official: RUSH, DAWN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
920 |
$20K |
| 2019 |
1,264 |
$30K |
| 2020 |
937 |
$23K |
| 2021 |
691 |
$17K |
| 2022 |
1,517 |
$37K |
| 2023 |
1,878 |
$49K |
| 2024 |
2,084 |
$82K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
3,253 |
3,134 |
$80K |
| D1120 |
Prophylaxis - child |
1,863 |
1,794 |
$67K |
| D1206 |
Topical application of fluoride varnish |
3,167 |
3,049 |
$65K |
| D1110 |
Prophylaxis - adult |
736 |
716 |
$40K |
| D0272 |
Bitewings - two radiographic images |
110 |
105 |
$2K |
| D1351 |
Sealant - per tooth |
51 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
85 |
82 |
$1K |
| D0274 |
Bitewings - four radiographic images |
26 |
26 |
$858.86 |