NPI: 1689748071 · OTTUMWA, IA 52501 · General Practice Dentistry · NPI assigned 11/20/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 120 | $2K |
| 2019 | 38 | $802.42 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 32 | 32 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 59 | 59 | $842.83 |
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 24 | $605.31 |
| D0330 | Panoramic radiographic image | 12 | 12 | $441.00 |
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $196.44 |
| D0603 | 18 | 18 | $90.00 |