NPI: 1437283165 · FLAGSTAFF, AZ 86004 · Dentist · NPI assigned 03/15/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 383 | $4K |
| 2019 | 107 | $1K |
| 2021 | 55 | $692.08 |
| 2022 | 257 | $3K |
| 2023 | 61 | $869.54 |
| 2024 | 52 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 255 | 219 | $4K |
| D1120 | Prophylaxis - child | 131 | 107 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 194 | 150 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 157 | 153 | $2K |
| D1206 | Topical application of fluoride varnish | 115 | 114 | $2K |
| D0274 | Bitewings - four radiographic images | 37 | 26 | $199.65 |
| D0230 | Intraoral - periapical each additional radiographic image | 14 | 14 | $107.58 |
| D1110 | Prophylaxis - adult | 12 | 12 | $86.98 |