WRATHALL, JODY
NPI: 1306142815
· PORTAGE, MI 49024
· Dentist
· NPI assigned 01/31/2011
$800.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
28 |
$800.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
14 |
14 |
$440.00 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$360.00 |