YELLOWSTONE DENTAL ASSOCIATES, PLLC
NPI: 1588293146
· POCATELLO, ID 83201
· General Practice Dentistry
· NPI assigned 04/06/2020
Provider Details
| Authorized Official | ASHCRAFT, TAYLOR (PRACTICE MANAGER) |
| NPI Enumeration Date | 04/06/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
399 |
$9K |
| 2022 |
464 |
$10K |
| 2023 |
361 |
$9K |
| 2024 |
101 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
417 |
417 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
404 |
404 |
$722.19 |
| D0220 |
Intraoral - periapical first radiographic image |
278 |
271 |
$262.30 |
| D0274 |
Bitewings - four radiographic images |
36 |
36 |
$68.66 |
| D0230 |
Intraoral - periapical each additional radiographic image |
175 |
103 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$0.00 |