BOONEVILLE GENERAL DENTISTRY, P.A.
NPI: 1881073716
· BOONEVILLE, MS 38829
· General Practice Dentistry
· NPI assigned 05/26/2015
Provider Details
| Authorized Official | HALL, SAMUEL (PRES) |
| NPI Enumeration Date | 05/26/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
348 |
$8K |
| 2022 |
610 |
$13K |
| 2023 |
422 |
$11K |
| 2024 |
218 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
616 |
564 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
498 |
452 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
416 |
380 |
$7K |
| D0274 |
Bitewings - four radiographic images |
39 |
38 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
14 |
12 |
$442.03 |
| D1206 |
Topical application of fluoride varnish |
15 |
14 |
$361.82 |