CASS COUNTY DENTAL CLINIC, LLC
NPI: 1134422280
· BELTON, MO 64012
· Public Health Dentist
· NPI assigned 12/13/2010
$894.95
Total Medicaid Paid
Provider Details
| Authorized Official | RANDAZZO, CYNTHIA (PRESIDENT/CEO) |
| Parent Organization | RESEARCH BELTON FOUNDATION SOLE M |
| NPI Enumeration Date | 12/13/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$165.12 |
| 2019 |
45 |
$729.83 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
46 |
43 |
$598.19 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$296.76 |