DONNA L RICK DDS PC
NPI: 1427675396
· FRUITPORT, MI 49415
· Dental Clinic/Center
· NPI assigned 06/26/2020
$805.70
Total Medicaid Paid
Provider Details
| Authorized Official | RICK, DONNA (PRESIDENT) |
| NPI Enumeration Date | 06/26/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
40 |
$805.70 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
28 |
28 |
$588.91 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$216.79 |