REGGIE H. BROOM, D.M.D., P.A.
NPI: 1215280672
· GULFPORT, MS 39507
· Pediatric Dentist
· NPI assigned 10/23/2012
$605.28
Total Medicaid Paid
Provider Details
| Authorized Official | BROOM, REGGIE (PEDIATRIC DENTIST/OWNER) |
| NPI Enumeration Date | 10/23/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
467 |
$605.28 |
| 2019 |
131 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
288 |
166 |
$605.28 |
| D0272 |
Bitewings - two radiographic images |
72 |
31 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
68 |
41 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
146 |
78 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
24 |
12 |
$0.00 |