NPI: 1548376270 · FARMINGTON, NM 87401 · Dentist · NPI assigned 08/23/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 50 | $1K |
| 2023 | 54 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 30 | 30 | $964.82 |
| D1208 | Topical application of fluoride, excluding varnish | 36 | 36 | $649.13 |
| D0120 | Periodic oral evaluation - established patient | 24 | 24 | $516.32 |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 12 | $374.50 |