WILSON DENTAL PC
NPI: 1487155867
· WYTHEVILLE, VA 24382
· General Practice Dentistry
· NPI assigned 02/22/2018
$942.00
Total Medicaid Paid
Provider Details
| Authorized Official | WILSON, ERIC (OWNER/PRESIDENT) |
| NPI Enumeration Date | 02/22/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$375.72 |
| 2021 |
12 |
$566.28 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$566.28 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$375.72 |