WALLACE, MARK
NPI: 1669467213
· SALT LAKE CITY, UT 84116
· General Practice Dentistry
· NPI assigned 09/20/2005
1,743
Beneficiary Records
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
751 |
$12K |
| 2019 |
1,074 |
$16K |
| 2020 |
720 |
$17K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
1,083 |
1,081 |
$42K |
| D1351 |
Sealant - per tooth |
1,077 |
368 |
$795.85 |
| D0190 |
|
13 |
13 |
$468.00 |
| D0220 |
Intraoral - periapical first radiographic image |
177 |
172 |
$366.03 |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
180 |
94 |
$0.00 |