NPI: 1689682882 · FARGO, ND 58103 · General Practice Dentistry · NPI assigned 08/03/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 523 | $16K |
| 2019 | 515 | $17K |
| 2020 | 370 | $11K |
| 2021 | 599 | $22K |
| 2022 | 239 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 685 | 665 | $35K |
| D0120 | Periodic oral evaluation - established patient | 695 | 681 | $18K |
| D1208 | Topical application of fluoride, excluding varnish | 618 | 598 | $14K |
| D0274 | Bitewings - four radiographic images | 164 | 164 | $6K |
| D1120 | Prophylaxis - child | 13 | 12 | $465.96 |
| D1999 | 71 | 63 | $0.00 |