REFRESH DENTISTRY
NPI: 1427455542
· BROKEN ARROW, OK 74011
· Preferred Provider Organization
· NPI assigned 12/04/2014
$506.15
Total Medicaid Paid
Provider Details
| Authorized Official | ARIANA, CATHY (REGIONAL DIRECTOR OF OPERATIONS) |
| NPI Enumeration Date | 12/04/2014 |
Related Entities
Other providers sharing the same authorized official: ARIANA, CATHY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
28 |
$506.15 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$277.55 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$228.60 |