MONMOUTH MALL DENTAL, PA
NPI: 1437591567
· EATONTOWN, NJ 07724
· 1223G0001X
$607.50
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
60 |
$607.50 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
|
34 |
34 |
$510.00 |
| D0220 |
|
26 |
26 |
$97.50 |