SOLOMON, STACY
NPI: 1720158280
· BROKEN BOW, NE 68822
· General Practice Dentistry
· NPI assigned 11/09/2006
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
389 |
$9K |
| 2019 |
283 |
$6K |
| 2020 |
127 |
$2K |
| 2021 |
13 |
$251.79 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
324 |
324 |
$7K |
| D1120 |
Prophylaxis - child |
171 |
171 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
209 |
192 |
$4K |
| D1110 |
Prophylaxis - adult |
25 |
25 |
$792.00 |
| D1999 |
|
59 |
54 |
$570.00 |
| D0274 |
Bitewings - four radiographic images |
24 |
24 |
$422.18 |