NPI: 1548611866 · MAGNA, UT 84044 · Dentist · NPI assigned 06/28/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 21 | $794.46 |
| 2019 | 105 | $6K |
| 2020 | 39 | $2K |
| 2021 | 118 | $2K |
| 2022 | 131 | $4K |
| 2023 | 141 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 132 | 132 | $13K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 27 | 15 | $3K |
| D9248 | 13 | 13 | $2K | |
| D0274 | Bitewings - four radiographic images | 78 | 78 | $1K |
| D1206 | Topical application of fluoride varnish | 169 | 169 | $1K |
| D2160 | 21 | 12 | $794.46 | |
| D1120 | Prophylaxis - child | 115 | 115 | $662.75 |