CHURCH, CHARLOTTE
NPI: 1407262827
· COLCHESTER, VT 05446
· General Practice Dentistry
· NPI assigned 07/07/2014
$878.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
34 |
$878.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
13 |
$471.00 |
| D0120 |
Periodic oral evaluation - established patient |
18 |
18 |
$407.00 |