JACKSON FAMILY DENTISTRY
NPI: 1457485732
· JACKSON, WY 83001
· General Practice Dentistry
· NPI assigned 03/16/2007
Provider Details
| Authorized Official | SMITH, CARY (GENERAL PARTNER) |
| NPI Enumeration Date | 03/16/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
95 |
$3K |
| 2019 |
37 |
$1K |
| 2020 |
60 |
$2K |
| 2021 |
338 |
$9K |
| 2022 |
510 |
$15K |
| 2023 |
648 |
$22K |
| 2024 |
373 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
898 |
835 |
$27K |
| D1110 |
Prophylaxis - adult |
381 |
344 |
$17K |
| D1206 |
Topical application of fluoride varnish |
516 |
475 |
$14K |
| D1120 |
Prophylaxis - child |
216 |
195 |
$6K |
| D0272 |
Bitewings - two radiographic images |
32 |
30 |
$625.95 |
| D0274 |
Bitewings - four radiographic images |
18 |
14 |
$554.58 |