NPI: 1578119244 · DANA POINT, CA 92629 · General Practice Dentistry · NPI assigned 08/17/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 135 | $932.53 |
| 2023 | 34 | $163.28 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 17 | 17 | $375.05 |
| D0220 | Intraoral - periapical first radiographic image | 31 | 30 | $339.12 |
| D1208 | Topical application of fluoride, excluding varnish | 19 | 19 | $220.50 |
| D0230 | Intraoral - periapical each additional radiographic image | 18 | 18 | $161.14 |
| D0603 | 84 | 80 | $0.00 |