CROSSWAY FAMILY DENTAL PA
NPI: 1700098241
· SOUTH PARIS, ME 04281
· Customized Equipment (DME)
· NPI assigned 05/04/2007
$686.94
Total Medicaid Paid
Provider Details
| Authorized Official | IM, AARON (OWNER DENTIST) |
| NPI Enumeration Date | 05/04/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
30 |
$686.94 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
16 |
14 |
$416.78 |
| D1206 |
Topical application of fluoride varnish |
14 |
12 |
$270.16 |