NPI: 1740920057 · PROVIDENCE, RI 02907 · Student in an Organized Health Care Education/Training Program · NPI assigned 04/01/2022
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 423 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 73 | 73 | $2K |
| D1206 | Topical application of fluoride varnish | 95 | 95 | $2K |
| D0120 | Periodic oral evaluation - established patient | 80 | 80 | $2K |
| D1110 | Prophylaxis - adult | 28 | 28 | $1K |
| D1310 | 82 | 82 | $1K | |
| D1330 | 34 | 34 | $433.16 | |
| D0272 | Bitewings - two radiographic images | 19 | 19 | $362.85 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $327.00 |