TO, GAVIN
NPI: 1699453118
· ELIZABETH, NJ 07201
· Dentist
· NPI assigned 07/05/2023
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
1,141 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
155 |
155 |
$6K |
| D1206 |
Topical application of fluoride varnish |
171 |
171 |
$5K |
| D1351 |
Sealant - per tooth |
218 |
47 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
142 |
142 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
152 |
150 |
$620.00 |
| D0272 |
Bitewings - two radiographic images |
61 |
61 |
$520.00 |
| D1353 |
|
51 |
12 |
$460.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
144 |
142 |
$369.00 |
| D0603 |
|
47 |
46 |
$310.00 |