ANDREW R. MORTENSEN, D.M.D., P.C.
NPI: 1457759177
· FORT COLLINS, CO 80524
· Public Health Dentist
· NPI assigned 12/11/2014
$864.12
Total Medicaid Paid
Provider Details
| Authorized Official | MORTENSEN, ANDREW (OWNER/PRESIDENT) |
| NPI Enumeration Date | 12/11/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
27 |
$864.12 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
13 |
12 |
$554.72 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$309.40 |