NPI: 1740595545 · KENSINGTON, MD 20895 · Dentist · NPI assigned 08/17/2010
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 349 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 101 | 101 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 26 | 15 | $4K |
| D1206 | Topical application of fluoride varnish | 105 | 105 | $3K |
| D0120 | Periodic oral evaluation - established patient | 28 | 28 | $890.68 |
| D0220 | Intraoral - periapical first radiographic image | 75 | 70 | $886.50 |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 14 | $788.76 |