CACHE VALLEY PEDIATRIC DENTISTRY
NPI: 1962282459
· LOGAN, UT 84341
· Dental Clinic/Center
· NPI assigned 10/02/2023
Provider Details
| Authorized Official | GIBBS, TORI (OFFICE MANAGER) |
| NPI Enumeration Date | 10/02/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
40 |
$35.37 |
| 2024 |
625 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
87 |
87 |
$7K |
| D1120 |
Prophylaxis - child |
57 |
57 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
278 |
276 |
$284.74 |
| D1206 |
Topical application of fluoride varnish |
212 |
212 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
17 |
17 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
14 |
14 |
$0.00 |