JACKSON, DAVID
NPI: 1699812644
· HANNIBAL, MO 63401
· General Practice Dentistry
· NPI assigned 01/31/2007
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
333 |
$9K |
| 2019 |
12 |
$322.92 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
50 |
44 |
$2K |
| D1120 |
Prophylaxis - child |
62 |
56 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
47 |
41 |
$1K |
| D1206 |
Topical application of fluoride varnish |
82 |
74 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
24 |
12 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
27 |
$925.00 |
| D0272 |
Bitewings - two radiographic images |
51 |
47 |
$816.00 |