NPI: 1407831837 · AVON, OH 44011 · General Practice Dentistry · NPI assigned 12/08/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 132 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 39 | 39 | $1K |
| D0274 | Bitewings - four radiographic images | 38 | 38 | $834.00 |
| D0330 | Panoramic radiographic image | 14 | 14 | $685.55 |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 14 | $378.18 |
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $247.67 |
| D0220 | Intraoral - periapical first radiographic image | 14 | 13 | $73.00 |