NPI: 1427392729 · MANASSAS, VA 20110 · General Practice Dentistry · NPI assigned 11/27/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 178 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 43 | 30 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 46 | 27 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 36 | 36 | $748.44 |
| D1120 | Prophylaxis - child | 15 | 15 | $502.80 |
| D0150 | Comprehensive oral evaluation - new or established patient | 23 | 16 | $500.96 |
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $302.25 |