NPI: 1255491130 · BRAZIL, IN 47834 · General Practice Dentistry · NPI assigned 12/11/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 898 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 221 | 195 | $621.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 45 | 30 | $403.50 |
| D0120 | Periodic oral evaluation - established patient | 258 | 230 | $343.12 |
| D0272 | Bitewings - two radiographic images | 95 | 84 | $173.67 |
| D1208 | Topical application of fluoride, excluding varnish | 208 | 184 | $126.00 |
| D1120 | Prophylaxis - child | 49 | 42 | $103.50 |
| D0220 | Intraoral - periapical first radiographic image | 22 | 17 | $66.25 |