MOELLER, RANDOLPH
NPI: 1053390443
· MUSKEGON HEIGHTS, MI 49444
· General Practice Dentistry
· NPI assigned 01/13/2006
$884.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
26 |
$884.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$520.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$364.00 |