CHILDREN'S DENTAL CLINIC, PA
NPI: 1619579349
· TUPELO, MS 38801
· Pediatric Dentist
· NPI assigned 11/09/2020
Provider Details
| Authorized Official | SUMNER, TRICE (PRESIDENT) |
| NPI Enumeration Date | 11/09/2020 |
Related Entities
Other providers sharing the same authorized official: SUMNER, TRICE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
104 |
$3K |
| 2021 |
1,229 |
$28K |
| 2022 |
1,064 |
$23K |
| 2023 |
337 |
$9K |
| 2024 |
774 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,055 |
954 |
$30K |
| D0120 |
Periodic oral evaluation - established patient |
966 |
867 |
$25K |
| D1206 |
Topical application of fluoride varnish |
779 |
723 |
$19K |
| D0272 |
Bitewings - two radiographic images |
317 |
270 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
182 |
145 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
122 |
98 |
$1K |
| D0330 |
Panoramic radiographic image |
17 |
16 |
$812.30 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$694.68 |
| D0230 |
Intraoral - periapical each additional radiographic image |
56 |
27 |
$595.96 |