NPI: 1538224001 · PORT HUENEME, CA 93041 · General Practice Dentistry · NPI assigned 12/26/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 128 | $4K |
| 2019 | 57 | $3K |
| 2020 | 13 | $540.00 |
| 2021 | 52 | $3K |
| 2022 | 27 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 79 | 79 | $6K |
| D0120 | Periodic oral evaluation - established patient | 144 | 141 | $6K |
| D1120 | Prophylaxis - child | 13 | 13 | $390.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 14 | 13 | $192.00 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $130.00 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $120.00 |