NPI: 1407901150 · ROSEVILLE, CA 95747 · General Practice Dentistry · NPI assigned 01/24/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 277 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 59 | 59 | $4K |
| D1120 | Prophylaxis - child | 47 | 47 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 126 | 47 | $510.30 |
| D1206 | Topical application of fluoride varnish | 30 | 30 | $310.00 |
| D0272 | Bitewings - two radiographic images | 15 | 15 | $180.00 |