NPI: 1508053414 · DOVER, OH 44622 · Dentist · NPI assigned 09/25/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 433 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 131 | 129 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 109 | 106 | $3K |
| D0120 | Periodic oral evaluation - established patient | 133 | 133 | $2K |
| D0330 | Panoramic radiographic image | 34 | 34 | $2K |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $295.00 |
| D1120 | Prophylaxis - child | 12 | 12 | $274.00 |