NPI: 1639811037 · WEBSTER, MA 01570 · Dentist · NPI assigned 04/07/2022
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 260 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 54 | 54 | $3K |
| D0120 | Periodic oral evaluation - established patient | 32 | 32 | $736.00 |
| D0220 | Intraoral - periapical first radiographic image | 69 | 69 | $660.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 85 | 50 | $429.00 |
| D0274 | Bitewings - four radiographic images | 20 | 20 | $385.00 |