NPI: 1033569447 · IMMOKALEE, FL 34142 · Dentist · NPI assigned 06/16/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 204 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 40 | 40 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 30 | 30 | $10.00 |
| D1330 | 42 | 42 | $0.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 51 | 28 | $0.00 |
| D1206 | Topical application of fluoride varnish | 41 | 41 | $0.00 |