ADAM M. GRUBLER DDS, PLLC
NPI: 1225672843
· BRIDGEPORT, WV 26330
· Dentist
· NPI assigned 11/06/2019
$584.52
Total Medicaid Paid
Provider Details
| Authorized Official | GRUBLER, ADAM (OWNER) |
| NPI Enumeration Date | 11/06/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$584.52 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$326.52 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$258.00 |