PERRY FAMILY DENTAL
NPI: 1518403328
· PERRY, OK 73077
· Dentist
· NPI assigned 01/18/2017
$605.82
Total Medicaid Paid
Provider Details
| Authorized Official | JAMES, WHITNEY (DENTIST) |
| NPI Enumeration Date | 01/18/2017 |
Related Entities
Other providers sharing the same authorized official: JAMES, WHITNEY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
13 |
$183.17 |
| 2019 |
12 |
$145.10 |
| 2021 |
13 |
$277.55 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$277.55 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$183.17 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$145.10 |