NPI: 1083824478 · BLYTHE, CA 92225 · Dentist · NPI assigned 05/23/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 381 | $6K |
| 2019 | 222 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 68 | 68 | $3K |
| D9430 | 66 | 66 | $2K | |
| D0210 | Intraoral - complete series of radiographic images | 31 | 31 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 120 | 119 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 264 | 79 | $995.48 |
| D1120 | Prophylaxis - child | 17 | 17 | $480.00 |
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $273.00 |
| D1208 | Topical application of fluoride, excluding varnish | 22 | 22 | $152.00 |