COPPER COVE PEDIATRIC DENTISTRY
NPI: 1134536907
· SOUTH JORDAN, UT 84095
· Pediatric Dentist
· NPI assigned 07/14/2014
Provider Details
| Authorized Official | HARDY, TROY (OWNER) |
| NPI Enumeration Date | 07/14/2014 |
Related Entities
Other providers sharing the same authorized official: HARDY, TROY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
63 |
$0.00 |
| 2019 |
350 |
$7K |
| 2020 |
376 |
$12K |
| 2021 |
579 |
$16K |
| 2022 |
313 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
455 |
453 |
$46K |
| D1120 |
Prophylaxis - child |
466 |
465 |
$985.20 |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$702.75 |
| D0220 |
Intraoral - periapical first radiographic image |
173 |
170 |
$127.28 |
| D0230 |
Intraoral - periapical each additional radiographic image |
241 |
118 |
$1.08 |
| D1206 |
Topical application of fluoride varnish |
302 |
302 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
14 |
$0.00 |
| D0330 |
Panoramic radiographic image |
15 |
15 |
$0.00 |