NPI: 1477800738 · BRISTOL, VT 05443 · Dentist · NPI assigned 08/06/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 781 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9920 | 57 | 57 | $0.00 | |
| D0120 | Periodic oral evaluation - established patient | 80 | 80 | $0.00 |
| D1206 | Topical application of fluoride varnish | 162 | 160 | $0.00 |
| D0272 | Bitewings - two radiographic images | 13 | 13 | $0.00 |
| D1351 | Sealant - per tooth | 185 | 43 | $0.00 |
| D1110 | Prophylaxis - adult | 74 | 74 | $0.00 |
| D0274 | Bitewings - four radiographic images | 69 | 69 | $0.00 |
| D1120 | Prophylaxis - child | 61 | 61 | $0.00 |
| D0330 | Panoramic radiographic image | 46 | 46 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 34 | 34 | $0.00 |