BLACKS FORK DENTAL, PC
NPI: 1508322603
· MT VIEW, WY 82939
· Dental Clinic/Center
· NPI assigned 02/13/2019
Provider Details
| Authorized Official | LESTER, NATHAN (PRESIDENT) |
| NPI Enumeration Date | 02/13/2019 |
Related Entities
Other providers sharing the same authorized official: LESTER, NATHAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
113 |
$860.00 |
| 2021 |
278 |
$5K |
| 2022 |
713 |
$16K |
| 2023 |
547 |
$13K |
| 2024 |
213 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
609 |
596 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
360 |
348 |
$10K |
| D1120 |
Prophylaxis - child |
132 |
131 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
312 |
286 |
$4K |
| D0274 |
Bitewings - four radiographic images |
92 |
90 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
40 |
15 |
$3K |
| D1110 |
Prophylaxis - adult |
41 |
41 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
187 |
70 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
16 |
15 |
$365.76 |
| D1999 |
|
75 |
60 |
$0.00 |