NPI: 1295285484 · JAMESTOWN, NY 14701 · Dentist · NPI assigned 10/11/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 60 | $8K |
| 2019 | 13 | $2K |
| 2021 | 71 | $1K |
| 2022 | 223 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9999 | Unspecified adjunctive procedure, by report | 73 | 70 | $9K |
| D1120 | Prophylaxis - child | 87 | 87 | $2K |
| D1206 | Topical application of fluoride varnish | 85 | 85 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 24 | $632.40 |
| D1354 | 35 | 12 | $525.00 | |
| D0272 | Bitewings - two radiographic images | 49 | 49 | $490.00 |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $239.12 |