FAMILY DENTAL HEALTH OF MOORE LLC
NPI: 1659047801
· MOORE, SC 29369
· General Practice Dentistry
· NPI assigned 08/18/2021
Provider Details
| Authorized Official | ILLSLEY, BETH (DIRECTOR OF INSURANCE) |
| Parent Organization | FDH HOLDINGS LLC |
| NPI Enumeration Date | 08/18/2021 |
Related Entities
Other providers sharing the same authorized official: ILLSLEY, BETH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
213 |
$6K |
| 2023 |
197 |
$6K |
| 2024 |
175 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
177 |
177 |
$7K |
| D1110 |
Prophylaxis - adult |
58 |
58 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
93 |
93 |
$2K |
| D1206 |
Topical application of fluoride varnish |
112 |
112 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
87 |
85 |
$1K |
| D0274 |
Bitewings - four radiographic images |
31 |
31 |
$752.71 |
| D0230 |
Intraoral - periapical each additional radiographic image |
27 |
27 |
$273.49 |