NPI: 1538720669 · MALVERN, AR 72104 · Dentist · NPI assigned 06/28/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 292 | $8K |
| 2020 | 127 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 161 | 159 | $4K |
| D1110 | Prophylaxis - adult | 50 | 48 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 113 | 113 | $2K |
| D0272 | Bitewings - two radiographic images | 83 | 83 | $2K |
| D1120 | Prophylaxis - child | 12 | 12 | $433.20 |