MSCTC COMMUNITY DENTAL CLINIC
NPI: 1548320112
· MOORHEAD, MN 56560
· Public Health Dentist
· NPI assigned 12/12/2006
Provider Details
| Authorized Official | BOE, THOMAS (DIRECTOR DENTAL DEPARTMENT) |
| NPI Enumeration Date | 12/12/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
651 |
$2K |
| 2019 |
560 |
$9K |
| 2020 |
170 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
275 |
268 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
197 |
194 |
$2K |
| D1206 |
Topical application of fluoride varnish |
263 |
258 |
$2K |
| D0274 |
Bitewings - four radiographic images |
90 |
87 |
$2K |
| D1330 |
|
468 |
426 |
$2K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$318.60 |
| D0210 |
Intraoral - complete series of radiographic images |
39 |
39 |
$216.60 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
37 |
37 |
$0.00 |