NPI: 1588150098 · EDMONDS, WA 98026 · Dentist · NPI assigned 07/09/2018
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 149 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 65 | 19 | $748.15 |
| D0120 | Periodic oral evaluation - established patient | 18 | 18 | $519.30 |
| D1120 | Prophylaxis - child | 12 | 12 | $441.00 |
| D1206 | Topical application of fluoride varnish | 20 | 20 | $294.00 |
| D0220 | Intraoral - periapical first radiographic image | 19 | 19 | $238.64 |
| D0602 | 15 | 15 | $0.00 |