MAUTHE, WILLIAM
NPI: 1598901605
· FOND DU LAC, WI 54935
· General Practice Dentistry
· NPI assigned 12/18/2008
$613.30
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$468.62 |
| 2019 |
13 |
$144.68 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$310.05 |
| D1206 |
Topical application of fluoride varnish |
26 |
26 |
$303.25 |