JAL HOSPITAL DISTRICT
NPI: 1982890737
· JAL, NM 88252
· General Practice Dentistry
· NPI assigned 09/14/2007
Provider Details
| Authorized Official | DECK, ERIN (BUSINESS ADMINISTRATOR) |
| NPI Enumeration Date | 09/14/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
14 |
$639.69 |
| 2023 |
96 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
27 |
27 |
$1K |
| D1120 |
Prophylaxis - child |
25 |
25 |
$757.50 |
| D1208 |
Topical application of fluoride, excluding varnish |
30 |
30 |
$528.57 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$511.51 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$128.20 |