STARLEY FAMILY DENTAL, LLC
NPI: 1851712467
· OGDEN, UT 84403
· Dental Clinic/Center
· NPI assigned 12/27/2013
$658.00
Total Medicaid Paid
Provider Details
| Authorized Official | STARLEY, JOHN (MANAGER) |
| NPI Enumeration Date | 12/27/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
17 |
$428.68 |
| 2024 |
14 |
$229.32 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
17 |
12 |
$428.68 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
12 |
$229.32 |