GRAY, JORDAN
NPI: 1548613086
· RUTLAND, VT 05701
· Dentist
· NPI assigned 07/20/2016
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
332 |
$9K |
| 2019 |
468 |
$11K |
| 2022 |
15 |
$406.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
212 |
204 |
$8K |
| D1206 |
Topical application of fluoride varnish |
269 |
258 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
224 |
214 |
$6K |
| D0272 |
Bitewings - two radiographic images |
27 |
27 |
$822.63 |
| D0220 |
Intraoral - periapical first radiographic image |
18 |
14 |
$188.34 |
| D0603 |
|
65 |
65 |
$0.03 |