CASEY A ROBERTS DDS PC
NPI: 1760664015
· DURANT, OK 74701
· General Practice Dentistry
· NPI assigned 11/28/2007
$800.76
Total Medicaid Paid
Provider Details
| Authorized Official | ROBERTS, CASEY (OWNER/DENTIST) |
| NPI Enumeration Date | 11/28/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
38 |
$800.76 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$394.80 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$236.88 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$169.08 |