CLOVER FAMILY DENTISTRY, LLC
NPI: 1346461563
· CLOVER, SC 29710
· General Practice Dentistry
· NPI assigned 05/02/2007
Provider Details
| Authorized Official | MYRICK, ERNEST (MEMBER) |
| NPI Enumeration Date | 05/02/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
241 |
$6K |
| 2019 |
155 |
$4K |
| 2020 |
15 |
$345.00 |
| 2024 |
15 |
$288.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
258 |
255 |
$6K |
| D1110 |
Prophylaxis - adult |
71 |
71 |
$3K |
| D1206 |
Topical application of fluoride varnish |
40 |
40 |
$648.00 |
| D0272 |
Bitewings - two radiographic images |
27 |
27 |
$511.38 |
| D0274 |
Bitewings - four radiographic images |
16 |
16 |
$412.65 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$226.80 |