TIMOTHY M PHILLIPS DDS INC
NPI: 1245721356
· LODI, OH 44254
· Dentist
· NPI assigned 05/24/2018
$639.12
Total Medicaid Paid
Provider Details
| Authorized Official | PHILLIPS, TIMOTHY (GENERAL DENTIST) |
| NPI Enumeration Date | 05/24/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$220.00 |
| 2019 |
26 |
$419.12 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$239.12 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$220.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$180.00 |