NPI: 1134543101 · MEQUON, WI 53092 · Preferred Provider Organization · NPI assigned 02/12/2014
| Authorized Official | SWEENEY, LISA (CFO/SECRETARY/TREASURER) |
| NPI Enumeration Date | 02/12/2014 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $34.82 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $34.82 |