NPI: 1497867964 · CLAY, WV 25043 · General Practice Dentistry · NPI assigned 08/31/2006
| Authorized Official | BOWEN, GARY (MEMBER) |
| NPI Enumeration Date | 08/31/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 308 | $6K |
| 2019 | 457 | $11K |
| 2020 | 12 | $323.15 |
| 2024 | 113 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 277 | 268 | $6K |
| D1208 | Topical application of fluoride, excluding varnish | 324 | 318 | $6K |
| D1120 | Prophylaxis - child | 176 | 172 | $6K |
| D0272 | Bitewings - two radiographic images | 59 | 58 | $1K |
| D0330 | Panoramic radiographic image | 14 | 14 | $804.00 |
| D1110 | Prophylaxis - adult | 13 | 13 | $715.00 |
| D0140 | Limited oral evaluation - problem focused | 27 | 24 | $525.00 |