SOUTHRIDGE DENTAL
NPI: 1891954343
· NAMPA, ID 83686
· General Practice Dentistry
· NPI assigned 06/09/2008
Provider Details
| Authorized Official | PRATT, ROBERT (DENTIST) |
| NPI Enumeration Date | 06/09/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
319 |
$6K |
| 2019 |
146 |
$4K |
| 2020 |
99 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
144 |
144 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
293 |
291 |
$182.38 |
| D0220 |
Intraoral - periapical first radiographic image |
27 |
26 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
41 |
41 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
46 |
25 |
$0.00 |