BLACKDUCK DENTAL CLINIC PSC
NPI: 1376814939
· BLACKDUCK, MN 56630
· General Practice Dentistry
· NPI assigned 01/13/2012
1,856
Beneficiary Records
Provider Details
| Authorized Official | LARSON, SCOTT (PRESIDENT) |
| NPI Enumeration Date | 01/13/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
217 |
$1K |
| 2019 |
278 |
$8K |
| 2020 |
273 |
$8K |
| 2021 |
221 |
$6K |
| 2022 |
254 |
$9K |
| 2023 |
381 |
$14K |
| 2024 |
245 |
$9K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,122 |
1,113 |
$30K |
| D1110 |
Prophylaxis - adult |
385 |
382 |
$15K |
| D1120 |
Prophylaxis - child |
123 |
123 |
$4K |
| D1206 |
Topical application of fluoride varnish |
139 |
138 |
$3K |
| D0274 |
Bitewings - four radiographic images |
100 |
100 |
$3K |