NPI: 1306152830 · FORT EUSTIS, VA 23604 · Dentist · NPI assigned 08/21/2010
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 341 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 167 | 167 | $4K |
| D1110 | Prophylaxis - adult | 39 | 39 | $1K |
| D1206 | Topical application of fluoride varnish | 72 | 72 | $1K |
| D1120 | Prophylaxis - child | 38 | 38 | $760.00 |
| D0272 | Bitewings - two radiographic images | 25 | 25 | $250.00 |