LAKE CITY FAMILY DENTISTRY
NPI: 1528686748
· LAKE CITY, MI 49651
· General Practice Dentistry
· NPI assigned 07/14/2020
Provider Details
| Authorized Official | MARSH, BETH (INSURANCE COORDINATOR) |
| NPI Enumeration Date | 07/14/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
437 |
$15K |
| 2021 |
460 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
212 |
212 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
202 |
202 |
$5K |
| D1206 |
Topical application of fluoride varnish |
181 |
181 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
50 |
50 |
$3K |
| D1110 |
Prophylaxis - adult |
69 |
69 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
76 |
76 |
$3K |
| D1351 |
Sealant - per tooth |
64 |
12 |
$1K |
| D0274 |
Bitewings - four radiographic images |
16 |
16 |
$510.02 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$312.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
13 |
$216.00 |