EAGLE ROCK DENTAL CARE OF REXBURG
NPI: 1831213149
· REXBURG, ID 83440
· General Practice Dentistry
· NPI assigned 03/19/2007
Provider Details
| Authorized Official | CHAPPLE, TRUDEE (ADMINISTRATOR) |
| NPI Enumeration Date | 03/19/2007 |
Related Entities
Other providers sharing the same authorized official: CHAPPLE, TRUDEE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
61 |
$1K |
| 2019 |
111 |
$2K |
| 2020 |
139 |
$4K |
| 2021 |
57 |
$0.00 |
| 2022 |
107 |
$2K |
| 2023 |
144 |
$4K |
| 2024 |
38 |
$735.44 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
106 |
105 |
$6K |
| D1120 |
Prophylaxis - child |
89 |
89 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
23 |
13 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
411 |
411 |
$54.35 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$0.00 |