NPI: 1710409081 · ROANOKE, AL 36274 · Dentist · NPI assigned 07/08/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 177 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 51 | 51 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 49 | 49 | $1K |
| D0120 | Periodic oral evaluation - established patient | 35 | 35 | $875.00 |
| D0272 | Bitewings - two radiographic images | 14 | 14 | $140.00 |
| D0220 | Intraoral - periapical first radiographic image | 16 | 16 | $80.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 12 | 12 | $54.00 |