MOUNTAIN SHORE PLLC
NPI: 1558909093
· POLSON, MT 59860
· Dental Clinic/Center
· NPI assigned 12/16/2019
Provider Details
| Authorized Official | RICKS, JOSHUA (DENTIST/OWNER) |
| NPI Enumeration Date | 12/16/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
26 |
$543.34 |
| 2022 |
214 |
$4K |
| 2023 |
516 |
$7K |
| 2024 |
221 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
637 |
364 |
$8K |
| D1110 |
Prophylaxis - adult |
195 |
106 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
130 |
76 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
12 |
$425.76 |