SHANNON, BRYAN
NPI: 1831825124
· PULASKI, TN 38478
· General Practice Dentistry
· NPI assigned 07/28/2022
$229.14
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
282 |
$229.14 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
78 |
50 |
$134.26 |
| D0120 |
Periodic oral evaluation - established patient |
90 |
58 |
$49.78 |
| D1208 |
Topical application of fluoride, excluding varnish |
92 |
57 |
$45.10 |
| D1120 |
Prophylaxis - child |
22 |
14 |
$0.00 |