NPI: 1528130788 · BAXTER, MN 56425 · Dental Clinic/Center · NPI assigned 11/14/2006
| Authorized Official | RUTMAN, ARNOLD (OWNER) |
| NPI Enumeration Date | 11/14/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 253 | $410.56 |
| 2019 | 278 | $7K |
| 2020 | 312 | $6K |
| 2021 | 182 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 572 | 568 | $8K |
| D1110 | Prophylaxis - adult | 251 | 249 | $7K |
| D0274 | Bitewings - four radiographic images | 117 | 115 | $2K |
| D1120 | Prophylaxis - child | 25 | 25 | $267.00 |
| D1999 | 47 | 37 | $0.00 | |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $0.00 |