MARSHALL, JOHN
NPI: 1205356425
· O FALLON, MO 63368
· General Practice Dentistry
· NPI assigned 06/20/2017
$914.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
103 |
$914.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
64 |
38 |
$350.00 |
| D0120 |
Periodic oral evaluation - established patient |
18 |
14 |
$300.00 |
| D1120 |
Prophylaxis - child |
21 |
15 |
$264.00 |