ANDREW STODDARD DENTAL SERVICES, PLLC
NPI: 1346501657
· POCATELLO, ID 83201
· Dental Clinic/Center
· NPI assigned 06/04/2012
Provider Details
| Authorized Official | STODDARD, ANDREW (SOLE MEMBER) |
| NPI Enumeration Date | 06/04/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
396 |
$8K |
| 2019 |
359 |
$7K |
| 2020 |
286 |
$5K |
| 2021 |
412 |
$7K |
| 2022 |
541 |
$12K |
| 2023 |
51 |
$943.99 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
572 |
571 |
$34K |
| D1120 |
Prophylaxis - child |
66 |
65 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
45 |
27 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
1,062 |
1,059 |
$142.54 |
| D0274 |
Bitewings - four radiographic images |
80 |
80 |
$129.57 |
| D0220 |
Intraoral - periapical first radiographic image |
113 |
110 |
$0.00 |
| D1999 |
|
16 |
16 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
59 |
59 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18 |
13 |
$0.00 |