NPI: 1154963098 · COTTONWOOD HEIGHTS, UT 84121 · General Practice Dentistry · NPI assigned 10/11/2019
| Authorized Official | HANSEN, JUSTIN (DENTIST) |
| NPI Enumeration Date | 10/11/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 188 | $1K |
| 2022 | 53 | $467.99 |
| 2023 | 567 | $8K |
| 2024 | 782 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 831 | 331 | $8K |
| D0274 | Bitewings - four radiographic images | 217 | 201 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 444 | 402 | $5K |
| D1110 | Prophylaxis - adult | 27 | 27 | $2K |
| D0120 | Periodic oral evaluation - established patient | 57 | 56 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 14 | $557.05 |