CAROLINA OAKS CLEMSON LLC
NPI: 1225466592
· CLEMSON, SC 29631
· Dental Clinic/Center
· NPI assigned 10/24/2013
$463.60
Total Medicaid Paid
Provider Details
| Authorized Official | WORKMAN, MARC (MEMBER) |
| NPI Enumeration Date | 10/24/2013 |
Related Entities
Other providers sharing the same authorized official: WORKMAN, MARC
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2020 |
12 |
$194.40 |
| 2021 |
12 |
$269.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$269.20 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$194.40 |