NPI: 1396868048 · SANDY, OR 97055 · Dentist · NPI assigned 04/09/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 339 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 83 | 82 | $2K |
| D1110 | Prophylaxis - adult | 30 | 30 | $1K |
| D0274 | Bitewings - four radiographic images | 40 | 40 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 76 | 75 | $934.00 |
| D1206 | Topical application of fluoride varnish | 43 | 43 | $786.80 |
| D0230 | Intraoral - periapical each additional radiographic image | 67 | 60 | $557.25 |