NPI: 1265465967 · DEER LODGE, MT 59722 · General Practice Dentistry · NPI assigned 07/08/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 506 | $13K |
| 2019 | 241 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 289 | 278 | $7K |
| D1120 | Prophylaxis - child | 182 | 177 | $6K |
| D1206 | Topical application of fluoride varnish | 178 | 173 | $4K |
| D1110 | Prophylaxis - adult | 44 | 40 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 28 | 27 | $896.91 |
| D0272 | Bitewings - two radiographic images | 26 | 26 | $537.07 |