INDEPENDENCE AVENUE DENTAL LLC
NPI: 1396982468
· INDEPENDENCE, MO 64050
· Dental Clinic/Center
· NPI assigned 01/12/2009
Provider Details
| Authorized Official | SILVER, RANDAL (OWNER) |
| NPI Enumeration Date | 01/12/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
190 |
$7K |
| 2019 |
104 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0274 |
Bitewings - four radiographic images |
166 |
163 |
$3K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
38 |
14 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
64 |
61 |
$2K |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$305.40 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$232.00 |