NPI: 1659769891 · SAINT CLOUD, FL 34769 · Dentist · NPI assigned 12/22/2014
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 126 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 48 | 48 | $1K |
| D1330 | 18 | 18 | $606.46 | |
| D1206 | Topical application of fluoride varnish | 19 | 19 | $16.35 |
| D0230 | Intraoral - periapical each additional radiographic image | 21 | 17 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 20 | 20 | $0.00 |