CASPER MOUNTAIN DENTAL
NPI: 1922470293
· GLENROCK, WY 82637
· General Practice Dentistry
· NPI assigned 10/27/2015
Provider Details
| Authorized Official | LARSEN, AARON (OWNER) |
| NPI Enumeration Date | 10/27/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
304 |
$11K |
| 2019 |
75 |
$3K |
| 2020 |
95 |
$4K |
| 2021 |
83 |
$3K |
| 2022 |
18 |
$374.40 |
| 2023 |
12 |
$468.00 |
| 2024 |
12 |
$670.34 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
149 |
146 |
$7K |
| D1206 |
Topical application of fluoride varnish |
190 |
190 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
122 |
119 |
$4K |
| D1120 |
Prophylaxis - child |
71 |
71 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
43 |
43 |
$1K |
| D0274 |
Bitewings - four radiographic images |
24 |
24 |
$770.00 |