NPI: 1649628447 · BRUSH, CO 80723 · Dental Hygienist · NPI assigned 06/02/2016
| Authorized Official | GONZALES, THERESE (OWNER) |
| NPI Enumeration Date | 06/02/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 231 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 46 | 46 | $2K |
| D1120 | Prophylaxis - child | 37 | 37 | $1K |
| D0274 | Bitewings - four radiographic images | 30 | 30 | $860.42 |
| D0272 | Bitewings - two radiographic images | 27 | 27 | $540.54 |
| D1206 | Topical application of fluoride varnish | 28 | 28 | $454.72 |
| D0220 | Intraoral - periapical first radiographic image | 35 | 35 | $416.50 |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $303.24 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $154.70 |