MOSS & ASSOCIATES GENERAL DENTISTRY LLC
NPI: 1144309196
· GREENWOOD, SC 29649
· Dentist
· NPI assigned 11/02/2006
$799.60
Total Medicaid Paid
Provider Details
| Authorized Official | MOSS, LEWIS (MANAGING MEMBER) |
| NPI Enumeration Date | 11/02/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$799.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$540.80 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$258.80 |