NPI: 1518073212 · TEMECULA, CA 92590 · Dentist · NPI assigned 08/22/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 175 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 91 | 87 | $2K |
| D1120 | Prophylaxis - child | 30 | 30 | $900.00 |
| D1110 | Prophylaxis - adult | 12 | 12 | $320.00 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $198.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 30 | 15 | $90.00 |