HUETTL, MACY
NPI: 1366018988
· WHEATON, IL 60187
· General Practice Dentistry
· NPI assigned 06/03/2021
$925.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
68 |
$925.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
26 |
26 |
$644.00 |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
16 |
$182.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$99.00 |
| D0603 |
|
13 |
12 |
$0.00 |