BROCKS GAP DENTAL GROUP, LLC
NPI: 1134787260
· HOOVER, AL 35244
· Dental Clinic/Center
· NPI assigned 06/04/2019
$590.00
Total Medicaid Paid
Provider Details
| Authorized Official | WEST, JOEY (PRACTICE ADMINISTRATOR) |
| NPI Enumeration Date | 06/04/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
19 |
$240.00 |
| 2021 |
64 |
$350.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
16 |
16 |
$350.00 |
| D1999 |
|
67 |
58 |
$240.00 |