NPI: 1144346909
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 61 | $4K |
| 2019 | 363 | $14K |
| 2020 | 684 | $18K |
| 2021 | 738 | $23K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 562 | 561 | $31K |
| D0120 | Periodic oral evaluation - established patient | 316 | 315 | $9K |
| D0274 | Bitewings - four radiographic images | 268 | 268 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 219 | 219 | $6K |
| D0210 | Intraoral - complete series of radiographic images | 41 | 41 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 128 | 128 | $2K |
| D1120 | Prophylaxis - child | 14 | 14 | $602.00 |
| D0220 | Intraoral - periapical first radiographic image | 26 | 26 | $348.88 |
| D1999 | 240 | 194 | $0.00 | |
| D9997 | 32 | 24 | $0.00 |