WORTHINGTON FAMILY DENTAL
NPI: 1942887823
· WORTHINGTON, MN 56187
· Dental Clinic/Center
· NPI assigned 03/26/2021
Provider Details
| Authorized Official | GROSSMAN, TRACY (OWNER/DENTIST) |
| NPI Enumeration Date | 03/26/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
65 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
25 |
25 |
$676.23 |
| D1206 |
Topical application of fluoride varnish |
24 |
24 |
$469.76 |
| D1120 |
Prophylaxis - child |
16 |
16 |
$420.50 |