NPI: 1740416379 · WEST VALLEY CITY, UT 84120 · General Practice Dentistry · NPI assigned 06/10/2009
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 139 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 22 | 22 | $808.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 44 | 22 | $465.93 |
| D1206 | Topical application of fluoride varnish | 22 | 22 | $388.27 |
| D0272 | Bitewings - two radiographic images | 15 | 15 | $358.12 |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $310.96 |
| D0220 | Intraoral - periapical first radiographic image | 22 | 22 | $296.58 |