NPI: 1710072277 · VILONIA, AR 72173 · General Practice Dentistry · NPI assigned 10/03/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 53 | $973.70 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $399.00 |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $239.40 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $178.55 |
| D0230 | Intraoral - periapical each additional radiographic image | 12 | 12 | $156.75 |