GRAY, JAMES
NPI: 1871506881
· OROFINO, ID 83544
· Dentist
· NPI assigned 08/14/2006
$527.78
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$0.00 |
| 2019 |
79 |
$429.41 |
| 2020 |
43 |
$79.13 |
| 2021 |
14 |
$19.24 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
108 |
108 |
$514.23 |
| D1206 |
Topical application of fluoride varnish |
41 |
41 |
$13.55 |