WILLOW DENTAL MILLARD, LLC
NPI: 1922834688
· OMAHA, NE 68137
· Dental Clinic/Center
· NPI assigned 09/10/2024
$408.57
Total Medicaid Paid
Provider Details
| Authorized Official | DAWSON, JACOB (DENTIST) |
| NPI Enumeration Date | 09/10/2024 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
26 |
$408.57 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$327.47 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
12 |
$81.10 |