REYNOLDS, JACK
NPI: 1295825123
· RICHMOND, IN 47374
· Pediatric Dentist
· NPI assigned 10/13/2006
$537.63
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
31 |
$537.63 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
17 |
15 |
$289.25 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
12 |
$248.38 |