FITCH, PHILLIP
NPI: 1669453718
· MANKATO, MN 56001
· General Practice Dentistry
· NPI assigned 11/07/2005
$943.16
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
357 |
$943.16 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
146 |
146 |
$664.20 |
| D0120 |
Periodic oral evaluation - established patient |
143 |
143 |
$278.96 |
| D0140 |
Limited oral evaluation - problem focused |
26 |
26 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
16 |
16 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$0.00 |