COVENANT FAMILY DENTISTRY
NPI: 1629561014
· WAYNESBORO, PA 17268
· General Practice Dentistry
· NPI assigned 06/11/2018
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
83 |
$2K |
| 2023 |
27 |
$684.00 |
| 2024 |
389 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
196 |
195 |
$5K |
| D1110 |
Prophylaxis - adult |
69 |
69 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
24 |
16 |
$2K |
| D1120 |
Prophylaxis - child |
46 |
46 |
$2K |
| D1206 |
Topical application of fluoride varnish |
54 |
54 |
$1K |
| D0274 |
Bitewings - four radiographic images |
30 |
30 |
$986.80 |
| D0330 |
Panoramic radiographic image |
17 |
17 |
$935.10 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16 |
14 |
$931.00 |
| D0601 |
|
47 |
47 |
$470.00 |