HAZELWOOD, AMY
NPI: 1457710568
· LAFAYETTE, CO 80026
· General Practice Dentistry
· NPI assigned 02/17/2016
$515.30
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
29 |
$515.30 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$333.20 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
14 |
$182.10 |