MERIDIAN PEDIATRIC DENTAL GROUP, LLC
NPI: 1356606511
· MERIDIAN, MS 39301
· Pediatric Dentist
· NPI assigned 07/12/2012
Provider Details
| Authorized Official | ELLIS, SHELLEY (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 07/12/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
55 |
$0.00 |
| 2020 |
12 |
$283.03 |
| 2021 |
367 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
185 |
153 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
122 |
118 |
$3K |
| D1206 |
Topical application of fluoride varnish |
75 |
75 |
$827.26 |
| D1208 |
Topical application of fluoride, excluding varnish |
28 |
28 |
$516.70 |
| D0272 |
Bitewings - two radiographic images |
24 |
24 |
$362.96 |