JACKSON, CHELSEA
NPI: 1235786013
· ANTHEM, AZ 85086
· Dentist
· NPI assigned 08/26/2019
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
227 |
$5K |
| 2021 |
131 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
84 |
84 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
50 |
50 |
$2K |
| D1110 |
Prophylaxis - adult |
38 |
38 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
54 |
54 |
$951.22 |
| D1206 |
Topical application of fluoride varnish |
40 |
40 |
$630.00 |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$315.00 |
| D0350 |
|
25 |
25 |
$307.75 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$260.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
21 |
12 |
$105.00 |
| D0220 |
Intraoral - periapical first radiographic image |
17 |
17 |
$85.00 |