316 FAMILY DENTAL LLC
NPI: 1679187686
· NEWTON, KS 67114
· General Practice Dentistry
· NPI assigned 09/08/2020
Provider Details
| Authorized Official | METTMAN, ANDREW (OWNER/DENTIST) |
| NPI Enumeration Date | 09/08/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
36 |
$255.40 |
| 2023 |
30 |
$874.26 |
| 2024 |
59 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
45 |
41 |
$838.60 |
| D1208 |
Topical application of fluoride, excluding varnish |
51 |
45 |
$609.18 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$568.44 |
| D1120 |
Prophylaxis - child |
17 |
13 |
$138.64 |