NPI: 1720472392 · PERU, IN 46970 · General Practice Dentistry · NPI assigned 03/23/2015
| Authorized Official | COHEE, BYRON (OWNER/PRESIDENT) |
| NPI Enumeration Date | 03/23/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 343 | $11K |
| 2020 | 82 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 188 | 174 | $4K |
| D1110 | Prophylaxis - adult | 90 | 81 | $4K |
| D1206 | Topical application of fluoride varnish | 87 | 81 | $2K |
| D1120 | Prophylaxis - child | 29 | 28 | $1K |
| D0330 | Panoramic radiographic image | 12 | 12 | $748.44 |
| D0274 | Bitewings - four radiographic images | 19 | 18 | $699.88 |