NPI: 1598351132 · KEYSER, WV 26726 · General Practice Dentistry · NPI assigned 12/17/2020
| Authorized Official | WHETZEL, JUSTIN (OWNER) |
| NPI Enumeration Date | 12/17/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 67 | $995.50 |
| 2024 | 348 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 105 | 105 | $3K |
| D1110 | Prophylaxis - adult | 45 | 44 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 106 | 105 | $2K |
| D1120 | Prophylaxis - child | 40 | 40 | $2K |
| D0330 | Panoramic radiographic image | 26 | 26 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 14 | 12 | $1K |
| D0274 | Bitewings - four radiographic images | 27 | 27 | $976.80 |
| D0140 | Limited oral evaluation - problem focused | 52 | 43 | $693.00 |