MADISON FAMILY DENTAL
NPI: 1184930059
· MADISON, SD 57042
· Dental Clinic/Center
· NPI assigned 08/29/2010
Provider Details
| Authorized Official | KEYES, TROY (OWNER) |
| NPI Enumeration Date | 08/29/2010 |
Related Entities
Other providers sharing the same authorized official: KEYES, TROY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
895 |
$26K |
| 2019 |
220 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
401 |
401 |
$11K |
| D1206 |
Topical application of fluoride varnish |
405 |
405 |
$9K |
| D1110 |
Prophylaxis - adult |
147 |
147 |
$7K |
| D1120 |
Prophylaxis - child |
136 |
136 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$607.62 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$321.00 |