NPI: 1588128235 · DERBY, CT 06418 · General Practice Dentistry · NPI assigned 01/28/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 101 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 15 | 15 | $0.00 |
| D1110 | Prophylaxis - adult | 16 | 15 | $0.00 |
| D0274 | Bitewings - four radiographic images | 16 | 16 | $0.00 |
| D1208 | Topical application of fluoride, excluding varnish | 27 | 26 | $0.00 |
| D0120 | Periodic oral evaluation - established patient | 27 | 27 | $0.00 |