NPI: 1518956606 · KINGSTON, NY 12401 · General Practice Dentistry · NPI assigned 10/20/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 29 | $187.36 |
| 2019 | 103 | $783.79 |
| 2021 | 59 | $579.50 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 113 | 110 | $808.11 |
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 24 | $273.77 |
| D1110 | Prophylaxis - adult | 14 | 14 | $187.80 |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $122.23 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $112.12 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $46.62 |