BEST SMILES FAMILY DENTAL QC
NPI: 1386040962
· DAVENPORT, IA 52806
· General Practice Dentistry
· NPI assigned 11/10/2014
Provider Details
| Authorized Official | RIVERA, MITCH (PRESIDENT) |
| NPI Enumeration Date | 11/10/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,379 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
157 |
147 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
280 |
269 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
209 |
200 |
$3K |
| D1120 |
Prophylaxis - child |
153 |
150 |
$3K |
| D0274 |
Bitewings - four radiographic images |
143 |
135 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
108 |
105 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
152 |
139 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
162 |
81 |
$841.16 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
12 |
$275.00 |