CLETUS A FONMEDIG DDS LLC
NPI: 1528807708
· ROSEDALE, MD 21237
· General Practice Dentistry
· NPI assigned 05/20/2024
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
305 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
81 |
81 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
43 |
43 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
80 |
80 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
41 |
41 |
$1K |
| D0330 |
Panoramic radiographic image |
27 |
27 |
$1K |
| D0274 |
Bitewings - four radiographic images |
33 |
33 |
$794.31 |