GENESIS DENTAL OF GRANGER
NPI: 1548685266
· WEST VALLEY CITY, UT 84120
· General Practice Dentistry
· NPI assigned 03/04/2014
$181.76
Total Medicaid Paid
Provider Details
| Authorized Official | CASTO, JASON (MEMBER/OWNER) |
| NPI Enumeration Date | 03/04/2014 |
Related Entities
Other providers sharing the same authorized official: CASTO, JASON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
31 |
$0.00 |
| 2019 |
16 |
$0.00 |
| 2024 |
13 |
$181.76 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
48 |
46 |
$181.76 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$0.00 |