STAR VALLEY DENTAL 1 LLC
NPI: 1497394068
· AFTON, WY 83110
· Dental Clinic/Center
· NPI assigned 12/31/2019
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
164 |
$5K |
| 2021 |
149 |
$5K |
| 2022 |
98 |
$3K |
| 2023 |
106 |
$3K |
| 2024 |
60 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
360 |
338 |
$11K |
| D1120 |
Prophylaxis - child |
104 |
95 |
$3K |
| D1110 |
Prophylaxis - adult |
44 |
41 |
$2K |
| D1206 |
Topical application of fluoride varnish |
33 |
32 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
36 |
29 |
$585.08 |