ROSE ROCK FAMILY DENTISTRY PLLC
NPI: 1235514183
· STILLWATER, OK 74074
· Customized Equipment (DME)
· NPI assigned 07/21/2015
$405.96
Total Medicaid Paid
Provider Details
| Authorized Official | BASSETT, SARA (OWNER/MANAGER) |
| NPI Enumeration Date | 07/21/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$405.96 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$236.88 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$169.08 |