NPI: 1518053412 · SALT LAKE CITY, UT 84106 · Dentist · NPI assigned 10/05/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,354 | $775K |
| 2019 | 588 | $359K |
| 2022 | 126 | $5K |
| 2023 | 12 | $745.39 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D8080 | Comprehensive orthodontic treatment of the adolescent dentition | 390 | 375 | $1.00M |
| D8680 | 282 | 277 | $81K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 698 | 697 | $54K |
| D0470 | 698 | 697 | $1K | |
| D8670 | Periodic orthodontic treatment visit | 12 | 12 | $240.00 |