NPI: 1568843464 · REYNOLDSBURG, OH 43068 · Dentist · NPI assigned 06/16/2015
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 66 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 28 | 26 | $579.70 |
| D1120 | Prophylaxis - child | 14 | 14 | $280.00 |
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $204.96 |
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $180.00 |