NPI: 1609140169 · OVERLAND PARK, KS 66213 · Dentist · NPI assigned 03/01/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 464 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 136 | 136 | $5K |
| D0120 | Periodic oral evaluation - established patient | 155 | 155 | $4K |
| D1206 | Topical application of fluoride varnish | 145 | 145 | $3K |
| D1110 | Prophylaxis - adult | 14 | 14 | $756.00 |
| D0220 | Intraoral - periapical first radiographic image | 14 | 14 | $221.00 |