NPI: 1568670123 · GLOUCESTER, MA 01930 · Periodontist · NPI assigned 05/18/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 106 | $1K |
| 2020 | 31 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 50 | 45 | $4K |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $427.40 |
| D0330 | Panoramic radiographic image | 13 | 13 | $106.85 |
| D0150 | Comprehensive oral evaluation - new or established patient | 42 | 42 | $106.85 |
| D1206 | Topical application of fluoride varnish | 19 | 19 | $106.85 |