KNOLLWOOD DENTAL GROUP
NPI: 1245407436
· MOBILE, AL 36609
· Dental Clinic/Center
· NPI assigned 05/15/2008
$618.00
Total Medicaid Paid
Provider Details
| Authorized Official | MARSHALL, KATIE (OFFICE MANAGER) |
| NPI Enumeration Date | 05/15/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
31 |
$618.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$330.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
16 |
16 |
$288.00 |