EAST PHILLIPS COUNTY HOSPITAL DISTRICT
NPI: 1235624990
· HOLYOKE, CO 80734
· General Practice Dentistry
· NPI assigned 06/26/2018
Provider Details
Related Entities
Other providers sharing the same authorized official: HASSELL, MICHAEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
72 |
$2K |
| 2020 |
87 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
71 |
70 |
$2K |
| D1206 |
Topical application of fluoride varnish |
46 |
46 |
$835.44 |
| D1110 |
Prophylaxis - adult |
16 |
16 |
$676.40 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$434.88 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
12 |
$228.60 |