MONTANA ROOTS DENTAL CARE PLLC
NPI: 1164935573
· HELENA, MT 59601
· Dental Clinic/Center
· NPI assigned 11/07/2017
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
95 |
$3K |
| 2019 |
258 |
$3K |
| 2020 |
14 |
$316.80 |
| 2021 |
41 |
$838.55 |
| 2022 |
12 |
$293.53 |
| 2023 |
26 |
$591.19 |
| 2024 |
16 |
$229.95 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
157 |
147 |
$3K |
| D1110 |
Prophylaxis - adult |
117 |
68 |
$3K |
| D1206 |
Topical application of fluoride varnish |
38 |
36 |
$884.72 |
| D1208 |
Topical application of fluoride, excluding varnish |
134 |
71 |
$831.28 |
| D0274 |
Bitewings - four radiographic images |
16 |
15 |
$472.92 |