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CLUBHOUSE PEDIATRIC DENTISTRY OF WEST JORDAN
CLUBHOUSE PEDIATRIC DENTISTRY OF WEST JORDAN
NPI: 1639654684
· MIDVALE, UT 84047
· 1223P0221X
$0.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
37 |
$0.00 |
| 2021 |
60 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0272 |
|
12 |
12 |
$0.00 |
| D1206 |
|
25 |
25 |
$0.00 |
| D0230 |
|
24 |
24 |
$0.00 |
| D1120 |
|
12 |
12 |
$0.00 |
| D0220 |
|
24 |
24 |
$0.00 |