NPI: 1699774729 · GLADSTONE, MO 64119 · General Practice Dentistry · NPI assigned 07/20/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 281 | $7K |
| 2019 | 39 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 172 | 170 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 27 | 27 | $1K |
| D0274 | Bitewings - four radiographic images | 37 | 37 | $775.00 |
| D0120 | Periodic oral evaluation - established patient | 27 | 27 | $647.00 |
| D0210 | Intraoral - complete series of radiographic images | 13 | 13 | $507.00 |
| D1208 | Topical application of fluoride, excluding varnish | 44 | 44 | $473.00 |