GUSTAFSON, MARK
NPI: 1114033214
· WOOSTER, OH 44691
· General Practice Dentistry
· NPI assigned 08/22/2006
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
239 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
63 |
61 |
$3K |
| D1110 |
Prophylaxis - adult |
57 |
55 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
63 |
61 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
43 |
42 |
$637.91 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
12 |
$250.64 |