NPI: 1447513361 · BEAVER, UT 84713 · General Practice Dentistry · NPI assigned 06/18/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 101 | $5K |
| 2022 | 174 | $8K |
| 2023 | 233 | $5K |
| 2024 | 215 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 190 | 185 | $13K |
| D0220 | Intraoral - periapical first radiographic image | 301 | 279 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 31 | 27 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 60 | 28 | $732.90 |
| D0274 | Bitewings - four radiographic images | 80 | 77 | $616.65 |
| D0140 | Limited oral evaluation - problem focused | 12 | 12 | $405.05 |
| D1120 | Prophylaxis - child | 37 | 37 | $259.58 |
| D1206 | Topical application of fluoride varnish | 12 | 12 | $0.00 |