NPI: 1376825505 · OAK HARBOR, WA 98277 · Dentist · NPI assigned 09/14/2011
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 41 | $2K |
| 2020 | 420 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 206 | 174 | $17K |
| D1120 | Prophylaxis - child | 73 | 37 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 71 | 36 | $1K |
| D1351 | Sealant - per tooth | 95 | 13 | $1K |
| D0120 | Periodic oral evaluation - established patient | 16 | 14 | $287.28 |