NPI: 1326029737 · CUBA, NY 14727 · Dentist · NPI assigned 11/11/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 330 | $10K |
| 2019 | 413 | $13K |
| 2020 | 263 | $10K |
| 2021 | 133 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 640 | 640 | $18K |
| D1110 | Prophylaxis - adult | 264 | 264 | $15K |
| D0274 | Bitewings - four radiographic images | 79 | 79 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 116 | 116 | $2K |
| D1120 | Prophylaxis - child | 28 | 28 | $1K |
| D0330 | Panoramic radiographic image | 12 | 12 | $470.00 |