MOUNTAIN CITY DENTAL, LLC
NPI: 1396249959
· FROSTBURG, MD 21532
· Dentist
· NPI assigned 03/20/2018
Provider Details
| Authorized Official | HOBEL, JORDAN (OWNER) |
| NPI Enumeration Date | 03/20/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
455 |
$14K |
| 2019 |
675 |
$18K |
| 2020 |
667 |
$19K |
| 2021 |
868 |
$24K |
| 2022 |
59 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
655 |
640 |
$26K |
| D1206 |
Topical application of fluoride varnish |
969 |
954 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
768 |
757 |
$21K |
| D1110 |
Prophylaxis - adult |
66 |
65 |
$4K |
| D1330 |
|
241 |
237 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$669.50 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$242.00 |