SHORELINE COMMUNITY COLLEGE
NPI: 1295925626
· SHORELINE, WA 98133
· Dental Clinic/Center
· NPI assigned 08/01/2007
$953.65
Total Medicaid Paid
Provider Details
| Authorized Official | TRIPPEL, STUART (ACTING VICE PRESIDENT FOR ADMINISTR) |
| NPI Enumeration Date | 08/01/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
45 |
$953.65 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
33 |
28 |
$535.48 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$418.17 |