TERRY L BOELTER DDS PC
NPI: 1467582023
· SANBORN, IA 51248
· General Practice Dentistry
· NPI assigned 03/06/2007
Provider Details
| Authorized Official | BOELTER, TERRY (OWNER) |
| NPI Enumeration Date | 03/06/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,077 |
$25K |
| 2019 |
1,087 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
746 |
702 |
$15K |
| D1110 |
Prophylaxis - adult |
339 |
321 |
$12K |
| D1206 |
Topical application of fluoride varnish |
640 |
604 |
$11K |
| D1120 |
Prophylaxis - child |
311 |
289 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
48 |
27 |
$3K |
| D0274 |
Bitewings - four radiographic images |
39 |
37 |
$1K |
| D0272 |
Bitewings - two radiographic images |
41 |
39 |
$885.63 |