WELVISTA
NPI: 1386727188
· SUMMERTON, SC 29148
· General Practice Dentistry
· NPI assigned 10/23/2006
Provider Details
| Authorized Official | FAMULINER, GEORGIA (OPERATIONS DIRECTOR) |
| NPI Enumeration Date | 10/23/2006 |
Related Entities
Other providers sharing the same authorized official: FAMULINER, GEORGIA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
644 |
$18K |
| 2019 |
568 |
$18K |
| 2020 |
282 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
158 |
103 |
$12K |
| D1120 |
Prophylaxis - child |
227 |
227 |
$8K |
| D1206 |
Topical application of fluoride varnish |
395 |
395 |
$6K |
| D0272 |
Bitewings - two radiographic images |
295 |
295 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
227 |
227 |
$5K |
| D2140 |
|
66 |
47 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
40 |
40 |
$2K |
| D1110 |
Prophylaxis - adult |
30 |
30 |
$2K |
| D0330 |
Panoramic radiographic image |
28 |
28 |
$1K |
| D0274 |
Bitewings - four radiographic images |
28 |
28 |
$770.28 |