RENFROE FAMILY DENTAL
NPI: 1104310895
· DOVER, TN 37058
· Dental Clinic/Center
· NPI assigned 06/18/2018
Provider Details
| Authorized Official | DAVIS, JORDAN (OFFICE MANAGER) |
| NPI Enumeration Date | 06/18/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
509 |
$13K |
| 2022 |
914 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
247 |
245 |
$9K |
| D1206 |
Topical application of fluoride varnish |
481 |
473 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
393 |
386 |
$9K |
| D1120 |
Prophylaxis - child |
262 |
255 |
$8K |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$497.30 |
| D0274 |
Bitewings - four radiographic images |
14 |
14 |
$399.84 |
| D0272 |
Bitewings - two radiographic images |
14 |
12 |
$203.83 |