NPI: 1376399899 · PROVIDENCE, RI 02905 · Dentist · NPI assigned 04/25/2024
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 761 | $61K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 367 | 300 | $59K |
| D0150 | Comprehensive oral evaluation - new or established patient | 200 | 179 | $1K |
| D0210 | Intraoral - complete series of radiographic images | 127 | 121 | $605.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 22 | 14 | $525.00 |
| D0220 | Intraoral - periapical first radiographic image | 32 | 30 | $36.00 |
| D0140 | Limited oral evaluation - problem focused | 13 | 13 | $0.00 |