NPI: 1124391271 · INGLEWOOD, CA 90303 · Dentist · NPI assigned 02/21/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 150 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 25 | 24 | $819.12 |
| D0120 | Periodic oral evaluation - established patient | 22 | 21 | $358.68 |
| D0274 | Bitewings - four radiographic images | 16 | 15 | $300.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 57 | 21 | $285.00 |
| D0220 | Intraoral - periapical first radiographic image | 30 | 27 | $140.00 |