NPI: 1366578890
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 355 | $9K |
| 2019 | 458 | $15K |
| 2020 | 714 | $19K |
| 2021 | 590 | $24K |
| 2022 | 39 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9430 | 899 | 891 | $28K | |
| D1110 | Prophylaxis - adult | 219 | 217 | $17K |
| D0150 | Comprehensive oral evaluation - new or established patient | 161 | 161 | $10K |
| D0220 | Intraoral - periapical first radiographic image | 715 | 684 | $8K |
| D0210 | Intraoral - complete series of radiographic images | 62 | 62 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 28 | 12 | $2K |
| D2920 | 17 | 12 | $672.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 55 | 30 | $234.21 |