LAKESHORE COMMUNITY DENTAL CLINIC
NPI: 1023275013
· CLEVELAND, WI 53015
· Dental Clinic/Center
· NPI assigned 05/19/2008
Provider Details
| Authorized Official | DODGE, BARBARA (DEAN, HEALTH AND HUMAN SERVICES) |
| NPI Enumeration Date | 05/19/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
246 |
$4K |
| 2019 |
206 |
$3K |
| 2020 |
86 |
$1K |
| 2021 |
215 |
$4K |
| 2022 |
310 |
$8K |
| 2023 |
181 |
$4K |
| 2024 |
45 |
$750.57 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
557 |
547 |
$9K |
| D1110 |
Prophylaxis - adult |
186 |
183 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
382 |
374 |
$6K |
| D1120 |
Prophylaxis - child |
75 |
75 |
$2K |
| D0274 |
Bitewings - four radiographic images |
62 |
62 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
27 |
27 |
$1K |