NPI: 1164626883 · HAYDEN, ID 83835 · Dentist · NPI assigned 06/14/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 38 | $615.14 |
| 2022 | 134 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30 | 30 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 28 | 28 | $767.28 |
| D9410 | 85 | 71 | $180.32 | |
| D1208 | Topical application of fluoride, excluding varnish | 16 | 16 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 12 | $0.00 |