NPI: 1508126772 · EL RENO, OK 73036 · General Practice Dentistry · NPI assigned 05/22/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 455 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 80 | 80 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 106 | 106 | $1K |
| D1120 | Prophylaxis - child | 51 | 51 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 98 | 98 | $1K |
| D0274 | Bitewings - four radiographic images | 30 | 30 | $846.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 78 | 76 | $549.90 |
| D1110 | Prophylaxis - adult | 12 | 12 | $507.48 |