R MATTHEW MADDOX DENTISTRY, LLC
NPI: 1093167884
· HARTFORD CITY, IN 47348
· Dentist
· NPI assigned 07/06/2016
$528.99
Total Medicaid Paid
Provider Details
| Authorized Official | MADDOX, RAYMOND (OWNER/DENTIST) |
| NPI Enumeration Date | 07/06/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
60 |
$8.58 |
| 2019 |
29 |
$520.41 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
59 |
57 |
$279.54 |
| D1208 |
Topical application of fluoride, excluding varnish |
30 |
28 |
$249.45 |