NPI: 1154587673 · PERRYVILLE, MO 63775 · General Practice Dentistry · NPI assigned 08/04/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 563 | $11K |
| 2019 | 501 | $9K |
| 2020 | 214 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 429 | 406 | $10K |
| D0272 | Bitewings - two radiographic images | 381 | 370 | $5K |
| D1120 | Prophylaxis - child | 150 | 149 | $3K |
| D1110 | Prophylaxis - adult | 59 | 53 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 127 | 127 | $1K |
| D9110 | 27 | 25 | $939.28 | |
| D2140 | 23 | 13 | $817.00 | |
| D0220 | Intraoral - periapical first radiographic image | 69 | 53 | $582.66 |
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 13 | $429.00 |