NPI: 1417572892 · DEER PARK, WA 99006 · Dentist · NPI assigned 06/11/2020
| Authorized Official | MONTANO, SANDY (OWNER) |
| NPI Enumeration Date | 06/11/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 29 | $230.00 |
| 2021 | 184 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9110 | 56 | 48 | $4K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 34 | 31 | $1K |
| D0140 | Limited oral evaluation - problem focused | 38 | 33 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 42 | 37 | $455.68 |
| D1999 | 29 | 19 | $230.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 14 | 13 | $35.52 |