ELLIOTT, THOMAS
NPI: 1689710170
· CICERO, IN 46034
· General Practice Dentistry
· NPI assigned 01/30/2007
$963.79
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$963.79 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$658.98 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$304.81 |