INGRAM, AUSTIN
NPI: 1154982338
· STUTTGART, AR 72160
· General Practice Dentistry
· NPI assigned 06/27/2019
$558.60
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$558.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$319.20 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$239.40 |