TOM J. MILIUS DDS, PEDIATRIC DENTISTRY, PC
NPI: 1194090969
· LINCOLN, NE 68506
· Pediatric Dentist
· NPI assigned 03/13/2012
$796.44
Total Medicaid Paid
Provider Details
| Authorized Official | MILIUS, TOM (PRESIDENT) |
| NPI Enumeration Date | 03/13/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
26 |
$796.44 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$450.12 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$346.32 |