SCENIC RIVER DENTAL LLC
NPI: 1295298685
· SAINT CROIX FALLS, WI 54024
· Dentist
· NPI assigned 04/11/2019
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | LINDBERG, JOE (OWNER) |
| NPI Enumeration Date | 04/11/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
31 |
$0.00 |
| 2022 |
14 |
$0.00 |
| 2024 |
528 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
138 |
127 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
49 |
28 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
179 |
166 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
21 |
12 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
70 |
69 |
$0.00 |
| D1120 |
Prophylaxis - child |
102 |
97 |
$0.00 |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$0.00 |