GOPLEN, MARISSA
NPI: 1629459102
· MONTEVIDEO, MN 56265
· General Practice Dentistry
· NPI assigned 06/10/2015
$0.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
99 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
32 |
32 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
39 |
39 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
16 |
15 |
$0.00 |
| D1330 |
|
12 |
12 |
$0.00 |