SMALLEY, JACK
NPI: 1487611331
· FARMINGTON, NM 87402
· Dentist
· NPI assigned 04/26/2006
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
44 |
$1K |
| 2021 |
163 |
$5K |
| 2022 |
32 |
$850.22 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
132 |
132 |
$5K |
| D1206 |
Topical application of fluoride varnish |
70 |
70 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
12 |
$731.76 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$376.75 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$267.24 |