NPI: 1063947307 · HUGO, MN 55038 · Dental Clinic/Center · NPI assigned 04/24/2017
| Authorized Official | SORENSON, BRENT (OWNER) |
| NPI Enumeration Date | 04/24/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 337 | $6K |
| 2020 | 287 | $5K |
| 2021 | 71 | $1K |
| 2022 | 12 | $474.65 |
| 2023 | 13 | $228.67 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 231 | 230 | $5K |
| D1110 | Prophylaxis - adult | 90 | 90 | $3K |
| D1120 | Prophylaxis - child | 67 | 67 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 95 | 94 | $1K |
| D1206 | Topical application of fluoride varnish | 60 | 60 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 101 | 89 | $851.87 |
| D0150 | Comprehensive oral evaluation - new or established patient | 31 | 31 | $788.48 |
| D0274 | Bitewings - four radiographic images | 29 | 29 | $723.85 |
| D1999 | 16 | 14 | $0.00 |