CMH DENTAL
NPI: 1184895153
· YUKON, OK 73099
· General Practice Dentistry
· NPI assigned 03/18/2008
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
625 |
$15K |
| 2019 |
308 |
$8K |
| 2020 |
204 |
$5K |
| 2021 |
81 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
668 |
668 |
$14K |
| D1120 |
Prophylaxis - child |
285 |
285 |
$8K |
| D1110 |
Prophylaxis - adult |
113 |
113 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
98 |
98 |
$1K |
| D0330 |
Panoramic radiographic image |
16 |
16 |
$721.60 |
| D0272 |
Bitewings - two radiographic images |
25 |
25 |
$423.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$364.60 |