NPI: 1619313301 · SANTA MONICA, CA 90404 · General Practice Dentistry · NPI assigned 05/21/2013
| Authorized Official | XU, HONGBO (OWNER) |
| NPI Enumeration Date | 05/21/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 518 | $10K |
| 2019 | 441 | $12K |
| 2020 | 386 | $12K |
| 2021 | 267 | $7K |
| 2022 | 25 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 367 | 367 | $15K |
| D1120 | Prophylaxis - child | 394 | 394 | $12K |
| D1110 | Prophylaxis - adult | 49 | 49 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 394 | 389 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 38 | 38 | $2K |
| D0274 | Bitewings - four radiographic images | 113 | 113 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 282 | 280 | $2K |