COWETA FAMILY DENTAL
NPI: 1225476716
· COWETA, OK 74429
· Dentist
· NPI assigned 06/06/2013
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
208 |
$4K |
| 2022 |
171 |
$3K |
| 2023 |
13 |
$131.73 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
111 |
111 |
$2K |
| D1206 |
Topical application of fluoride varnish |
124 |
123 |
$2K |
| D1110 |
Prophylaxis - adult |
27 |
27 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
65 |
65 |
$822.96 |
| D0230 |
Intraoral - periapical each additional radiographic image |
53 |
43 |
$358.14 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$274.50 |