NPI: 1003891490 · MILLINGTON, TN 38054 · Dentist · NPI assigned 12/08/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $239.00 |
| 2021 | 291 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 58 | 57 | $2K |
| D1206 | Topical application of fluoride varnish | 99 | 99 | $2K |
| D0120 | Periodic oral evaluation - established patient | 51 | 51 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 36 | 36 | $1K |
| D1120 | Prophylaxis - child | 29 | 29 | $1K |
| D0330 | Panoramic radiographic image | 30 | 30 | $1K |