EVANS DENTAL PA
NPI: 1205306941
· BURLEY, ID 83318
· Dental Clinic/Center
· NPI assigned 11/26/2018
Provider Details
| Authorized Official | EVANS, MARK (DENTIST/OWNER) |
| NPI Enumeration Date | 11/26/2018 |
Related Entities
Other providers sharing the same authorized official: EVANS, MARK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$417.21 |
| 2020 |
431 |
$8K |
| 2021 |
341 |
$6K |
| 2022 |
218 |
$5K |
| 2023 |
29 |
$895.56 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
240 |
240 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
127 |
127 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
56 |
56 |
$443.16 |
| D0274 |
Bitewings - four radiographic images |
82 |
82 |
$60.47 |
| D0120 |
Periodic oral evaluation - established patient |
112 |
112 |
$19.24 |
| D0220 |
Intraoral - periapical first radiographic image |
133 |
133 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
35 |
35 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
246 |
246 |
$0.00 |