SMILE CULTURE DENTAL PC
NPI: 1144698028
· FAIRLESS HILLS, PA 19030
· Dentist
· NPI assigned 09/09/2015
$393.40
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
52 |
$393.40 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$276.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
13 |
$77.65 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
12 |
$39.75 |
| D1330 |
|
13 |
13 |
$0.00 |