WALLACE, DUSTIN
NPI: 1770932808
· PINE BLUFF, AR 71603
· General Practice Dentistry
· NPI assigned 06/09/2016
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
948 |
$33K |
| 2019 |
407 |
$12K |
| 2020 |
83 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
550 |
447 |
$14K |
| D1110 |
Prophylaxis - adult |
277 |
211 |
$12K |
| D0330 |
Panoramic radiographic image |
132 |
83 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
61 |
43 |
$5K |
| D1120 |
Prophylaxis - child |
121 |
83 |
$4K |
| D1206 |
Topical application of fluoride varnish |
156 |
111 |
$3K |
| D0272 |
Bitewings - two radiographic images |
82 |
73 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
43 |
39 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
16 |
$270.75 |