NPI: 1689342438 · HYATTSVILLE, MD 20782 · Dentist · NPI assigned 09/04/2021
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 151 | $4K |
| 2023 | 193 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 33 | 33 | $2K |
| D1206 | Topical application of fluoride varnish | 59 | 59 | $1K |
| D0120 | Periodic oral evaluation - established patient | 57 | 57 | $1K |
| D0274 | Bitewings - four radiographic images | 35 | 35 | $1K |
| D9630 | 41 | 41 | $1K | |
| D0220 | Intraoral - periapical first radiographic image | 62 | 62 | $900.86 |
| D0230 | Intraoral - periapical each additional radiographic image | 57 | 44 | $828.21 |