EDGEWATER DENTAL
NPI: 1891967659
· NAMPA, ID 83686
· Health Maintenance Organization
· NPI assigned 04/01/2008
Provider Details
| Authorized Official | MILICH, RHONDA (RECEPTIONIST) |
| NPI Enumeration Date | 04/01/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
83 |
$1K |
| 2019 |
13 |
$626.01 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
42 |
42 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
42 |
42 |
$0.55 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |