PORTNEUF VALLEY DENTAL
NPI: 1770127565
· POCATELLO, ID 83201
· Dental Clinic/Center
· NPI assigned 11/05/2019
Provider Details
| Authorized Official | BIRD, JAYSON (CEO/OWNER) |
| NPI Enumeration Date | 11/05/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
477 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
100 |
100 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
28 |
28 |
$3K |
| D0330 |
Panoramic radiographic image |
28 |
28 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
82 |
82 |
$468.98 |
| D0120 |
Periodic oral evaluation - established patient |
77 |
77 |
$151.38 |
| D0274 |
Bitewings - four radiographic images |
33 |
33 |
$49.42 |
| D0230 |
Intraoral - periapical each additional radiographic image |
70 |
37 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
59 |
58 |
$0.00 |