NIC JORGE DENTAL, LLC
NPI: 1821832569
· ELLICOTT CITY, MD 21043
· General Practice Dentistry
· NPI assigned 06/19/2024
Provider Details
| Authorized Official | JORGE, NICOLAS (DENTIST) |
| NPI Enumeration Date | 06/19/2024 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
179 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
68 |
68 |
$2K |
| D1120 |
Prophylaxis - child |
29 |
29 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
53 |
53 |
$1K |
| D1110 |
Prophylaxis - adult |
17 |
17 |
$1K |
| D1330 |
|
12 |
12 |
$86.40 |