NPI: 1306866553 · KINGS MOUNTAIN, NC 28086 · General Practice Dentistry · NPI assigned 07/20/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 387 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 109 | 104 | $4K |
| D0120 | Periodic oral evaluation - established patient | 148 | 144 | $3K |
| D0274 | Bitewings - four radiographic images | 66 | 62 | $2K |
| D1120 | Prophylaxis - child | 40 | 40 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $188.64 |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $175.90 |