NETTLETON DENTAL LLC
NPI: 1780303677
· NETTLETON, MS 38858
· Dental Clinic/Center
· NPI assigned 08/24/2022
Provider Details
| Authorized Official | GOODMAN, AMBRIE (DENTIST) |
| NPI Enumeration Date | 08/24/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
279 |
$3K |
| 2023 |
1,047 |
$22K |
| 2024 |
743 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
424 |
361 |
$15K |
| D1120 |
Prophylaxis - child |
274 |
238 |
$7K |
| D0330 |
Panoramic radiographic image |
208 |
186 |
$7K |
| D1206 |
Topical application of fluoride varnish |
193 |
171 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
733 |
422 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
108 |
79 |
$3K |
| D0274 |
Bitewings - four radiographic images |
95 |
72 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
34 |
30 |
$926.08 |