BOYS AND GIRLS CLUB OF PORTAGE COUNTY
NPI: 1962916650
· STEVENS POINT, WI 54481
· Dental Hygienist
· NPI assigned 11/17/2017
Provider Details
| Authorized Official | GUTIERREZ, MELISSA (SMILE CLUB COORDINATOR) |
| NPI Enumeration Date | 11/17/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
39 |
$601.92 |
| 2020 |
28 |
$442.30 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
30 |
29 |
$608.96 |
| D1206 |
Topical application of fluoride varnish |
37 |
36 |
$435.26 |