NPI: 1316166218 · PULLMAN, WA 99163 · Dentist · NPI assigned 04/25/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 306 | $2K |
| 2019 | 860 | $12K |
| 2021 | 102 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 47 | 47 | $8K |
| D0120 | Periodic oral evaluation - established patient | 40 | 40 | $6K |
| D1120 | Prophylaxis - child | 205 | 205 | $277.08 |
| D0220 | Intraoral - periapical first radiographic image | 163 | 163 | $66.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 490 | 162 | $0.00 |
| D0272 | Bitewings - two radiographic images | 26 | 26 | $0.00 |
| D1206 | Topical application of fluoride varnish | 204 | 204 | $0.00 |
| D1351 | Sealant - per tooth | 47 | 12 | $0.00 |
| D0274 | Bitewings - four radiographic images | 46 | 46 | $0.00 |