CRISDENTAL GRANTS PASS LLC
NPI: 1790239697
· GRANTS PASS, OR 97526
· General Practice Dentistry
· NPI assigned 08/09/2016
Provider Details
| Authorized Official | BRATLAND, MICHAEL (OWNER) |
| Parent Organization | CRISDENTAL GROUP PC |
| NPI Enumeration Date | 08/09/2016 |
Related Entities
Other providers sharing the same authorized official: BRATLAND, MICHAEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
14,214 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
336 |
318 |
$982.00 |
| D0210 |
Intraoral - complete series of radiographic images |
153 |
152 |
$802.00 |
| D0603 |
|
2,004 |
1,786 |
$572.00 |
| D0140 |
Limited oral evaluation - problem focused |
485 |
464 |
$521.00 |
| D4342 |
|
105 |
30 |
$414.00 |
| D0191 |
|
610 |
575 |
$414.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
250 |
244 |
$395.00 |
| D1110 |
Prophylaxis - adult |
118 |
115 |
$329.00 |
| D1354 |
|
6,678 |
409 |
$308.00 |
| D0220 |
Intraoral - periapical first radiographic image |
505 |
480 |
$238.00 |
| D1120 |
Prophylaxis - child |
131 |
124 |
$200.00 |
| D4341 |
|
77 |
28 |
$180.00 |
| D0274 |
Bitewings - four radiographic images |
97 |
97 |
$116.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
371 |
180 |
$90.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
13 |
$71.00 |
| D0601 |
|
30 |
30 |
$22.00 |
| D0270 |
|
37 |
36 |
$22.00 |
| D1320 |
|
12 |
12 |
$0.00 |
| D1330 |
|
2,153 |
1,926 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$0.00 |
| D0460 |
|
34 |
30 |
$0.00 |