NPI: 1114588043 · CLARKS SUMMIT, PA 18411 · General Practice Dentistry · NPI assigned 06/21/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 14 | $400.00 |
| 2021 | 247 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | 73 | 36 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 87 | 87 | $2K |
| D1110 | Prophylaxis - adult | 35 | 35 | $1K |
| D0120 | Periodic oral evaluation - established patient | 40 | 39 | $800.00 |
| D0330 | Panoramic radiographic image | 13 | 13 | $481.00 |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $360.00 |