BRENT CLINE DDS PLLC
NPI: 1346702461
· IDAHO FALLS, ID 83401
· Dental Clinic/Center
· NPI assigned 04/05/2019
$926.12
Total Medicaid Paid
Provider Details
| Authorized Official | CLINE, BRENT (DENTIST) |
| NPI Enumeration Date | 04/05/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
25 |
$926.12 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$926.12 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |