QUEEN CITY DENTAL STUDIO
NPI: 1346691201
· HELENA, MT 59601
· Dentist
· NPI assigned 06/22/2016
Provider Details
| Authorized Official | MARTIN, CHARISSA (DENTIST/OWNER) |
| NPI Enumeration Date | 06/22/2016 |
Related Entities
Other providers sharing the same authorized official: MARTIN, CHARISSA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
13 |
$164.87 |
| 2023 |
114 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
26 |
26 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
45 |
42 |
$656.16 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$425.76 |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
26 |
$217.93 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$198.72 |