CEDAR DRIVE FAMILY DENTISTRY
NPI: 1235685843
· SAINT STEPHEN, SC 29479
· General Practice Dentistry
· NPI assigned 09/01/2016
Provider Details
| Authorized Official | CADDELL, LAURA (OWNER) |
| NPI Enumeration Date | 09/01/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
109 |
$4K |
| 2019 |
65 |
$2K |
| 2020 |
13 |
$276.00 |
| 2021 |
13 |
$210.60 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
37 |
37 |
$2K |
| D0330 |
Panoramic radiographic image |
33 |
33 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
77 |
77 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
40 |
40 |
$648.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$526.50 |