NPI: 1669075917 · JONESBORO, AR 72401 · Dental Clinic/Center · NPI assigned 11/19/2020
| Authorized Official | HUTCHESON, JESSICA (OFFICE MANAGER) |
| NPI Enumeration Date | 11/19/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 477 | $12K |
| 2022 | 661 | $16K |
| 2023 | 319 | $8K |
| 2024 | 43 | $902.21 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 470 | 466 | $11K |
| D1110 | Prophylaxis - adult | 233 | 233 | $10K |
| D0272 | Bitewings - two radiographic images | 379 | 376 | $8K |
| D1206 | Topical application of fluoride varnish | 406 | 404 | $7K |
| D1120 | Prophylaxis - child | 12 | 12 | $397.10 |