WASHINGTON, BRANDON
NPI: 1255627329
· SHIPROCK, NM 87420
· General Practice Dentistry
· NPI assigned 06/27/2011
$950.28
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
63 |
$950.28 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$375.43 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$289.85 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
12 |
$165.00 |
| D0220 |
Intraoral - periapical first radiographic image |
25 |
24 |
$120.00 |