ERIC J. WISDOM D.D.S., P.A.
NPI: 1861418469
· MANHATTAN, KS 66502
· General Practice Dentistry
· NPI assigned 07/15/2006
Provider Details
| Authorized Official | WISDOM, ERIC (OWNER) |
| NPI Enumeration Date | 07/15/2006 |
Related Entities
Other providers sharing the same authorized official: WISDOM, ERIC
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,099 |
$23K |
| 2019 |
1,315 |
$33K |
| 2020 |
187 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
648 |
625 |
$13K |
| D1206 |
Topical application of fluoride varnish |
704 |
676 |
$11K |
| D1120 |
Prophylaxis - child |
379 |
361 |
$10K |
| D1110 |
Prophylaxis - adult |
200 |
192 |
$8K |
| D1351 |
Sealant - per tooth |
288 |
41 |
$7K |
| D0274 |
Bitewings - four radiographic images |
146 |
141 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
44 |
29 |
$3K |
| D0272 |
Bitewings - two radiographic images |
152 |
144 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
24 |
12 |
$2K |
| D0330 |
Panoramic radiographic image |
16 |
13 |
$772.00 |