NPI: 1093445082 · ST PAUL, MN 55104 · General Practice Dentistry · NPI assigned 06/13/2022
| Authorized Official | XIONG, KOLA (OWNER, DENTIST) |
| NPI Enumeration Date | 06/13/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 97 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 16 | 16 | $941.87 |
| D1110 | Prophylaxis - adult | 13 | 13 | $806.44 |
| D0150 | Comprehensive oral evaluation - new or established patient | 18 | 18 | $667.83 |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $479.37 |
| D0230 | Intraoral - periapical each additional radiographic image | 23 | 14 | $233.10 |
| D0220 | Intraoral - periapical first radiographic image | 14 | 14 | $209.78 |