SHASTA FAMILY DENTAL
NPI: 1427574136
· KLAMATH FALLS, OR 97601
· Dental Clinic/Center
· NPI assigned 08/15/2017
$968.16
Total Medicaid Paid
Provider Details
| Authorized Official | BROWN, MINDY (PRESIDENT) |
| NPI Enumeration Date | 08/15/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
357 |
$527.16 |
| 2019 |
692 |
$441.00 |
| 2020 |
375 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9630 |
|
30 |
26 |
$913.50 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
466 |
459 |
$54.66 |
| D0274 |
Bitewings - four radiographic images |
128 |
127 |
$0.00 |
| D9986 |
|
88 |
85 |
$0.00 |
| D1110 |
Prophylaxis - adult |
216 |
213 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
90 |
86 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
237 |
230 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
30 |
30 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
139 |
138 |
$0.00 |