ROBERT L. FACKRELL DDS PA
NPI: 1801225180
· POCATELLO, ID 83201
· Dentist
· NPI assigned 11/06/2013
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
28 |
$1K |
| 2021 |
12 |
$278.36 |
| 2022 |
62 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
25 |
24 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
65 |
65 |
$394.51 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$0.00 |