NPI: 1316036205 · ANDOVER, OH 44003 · General Practice Dentistry · NPI assigned 10/11/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 583 | $9K |
| 2019 | 382 | $5K |
| 2020 | 540 | $10K |
| 2021 | 282 | $5K |
| 2022 | 432 | $7K |
| 2023 | 72 | $1K |
| 2024 | 87 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 674 | 623 | $13K |
| D0120 | Periodic oral evaluation - established patient | 674 | 623 | $11K |
| D1208 | Topical application of fluoride, excluding varnish | 641 | 603 | $9K |
| D0272 | Bitewings - two radiographic images | 326 | 302 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 31 | 15 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 32 | 14 | $1K |