ONEIDA FAMILY DENTAL LLC
NPI: 1316454333
· MALAD CITY, ID 83252
· General Practice Dentistry
· NPI assigned 12/29/2017
Provider Details
| Authorized Official | CLARK, SHENELL (OFFICE MANAGER) |
| NPI Enumeration Date | 12/29/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
141 |
$4K |
| 2024 |
583 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
153 |
153 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
68 |
68 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
191 |
191 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
22 |
14 |
$1K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$448.97 |
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$256.65 |
| D0120 |
Periodic oral evaluation - established patient |
141 |
141 |
$78.21 |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
30 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
92 |
91 |
$0.00 |