NPI: 1568975274 · XENIA, OH 45385 · Dentist · NPI assigned 11/16/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 78 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 39 | 39 | $564.75 |
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 12 | $316.20 |
| D0140 | Limited oral evaluation - problem focused | 12 | 12 | $277.74 |
| D0220 | Intraoral - periapical first radiographic image | 14 | 13 | $68.00 |