NPI: 1194299941 · MONUMENT, CO 80132 · Dentist · NPI assigned 01/15/2019
| Authorized Official | HALL, VALERIE (BUSINESS MANAGER) |
| NPI Enumeration Date | 01/15/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 25 | $1K |
| 2020 | 488 | $17K |
| 2021 | 402 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 353 | 353 | $14K |
| D0274 | Bitewings - four radiographic images | 193 | 193 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 112 | 112 | $4K |
| D0120 | Periodic oral evaluation - established patient | 152 | 152 | $3K |
| D0330 | Panoramic radiographic image | 59 | 59 | $3K |
| D0140 | Limited oral evaluation - problem focused | 13 | 13 | $426.53 |
| D1206 | Topical application of fluoride varnish | 16 | 16 | $262.24 |
| D0220 | Intraoral - periapical first radiographic image | 17 | 17 | $204.34 |