VIVALDI, WALTER
NPI: 1811088966
· ANASCO, PR 00610
· General Practice Dentistry
· NPI assigned 09/27/2006
$622.80
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
31 |
$622.80 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
|
17 |
17 |
$459.00 |
| D0120 |
|
14 |
14 |
$163.80 |