NPI: 1619232881 · HENDERSONVILLE, TN 37075 · Dentist · NPI assigned 07/12/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 155 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 29 | 27 | $1K |
| D1206 | Topical application of fluoride varnish | 54 | 50 | $1K |
| D0120 | Periodic oral evaluation - established patient | 44 | 42 | $951.60 |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $395.92 |
| D1120 | Prophylaxis - child | 14 | 14 | $341.30 |