NPI: 1609238344 · WESTERVILLE, OH 43081 · General Practice Dentistry · NPI assigned 03/22/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 314 | $9K |
| 2021 | 230 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 165 | 165 | $6K |
| D0330 | Panoramic radiographic image | 119 | 118 | $5K |
| D0120 | Periodic oral evaluation - established patient | 116 | 116 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 70 | 70 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 18 | 12 | $921.78 |
| D0140 | Limited oral evaluation - problem focused | 29 | 27 | $584.08 |
| D0274 | Bitewings - four radiographic images | 27 | 27 | $540.00 |