TRI LAKES DENTISTRY, PLLC
NPI: 1699104109
· HOT SPRINGS, AR 71901
· General Practice Dentistry
· NPI assigned 11/05/2013
$851.20
Total Medicaid Paid
Provider Details
| Authorized Official | DELEE, NEAL (DENTIST) |
| NPI Enumeration Date | 11/05/2013 |
Related Entities
Other providers sharing the same authorized official: DELEE, NEAL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$558.60 |
| 2022 |
12 |
$292.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
36 |
24 |
$851.20 |