NPI: 1770577686 · KANSAS CITY, KS 66102 · General Practice Dentistry · NPI assigned 09/07/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 151 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 24 | $946.03 |
| D1120 | Prophylaxis - child | 18 | 18 | $389.70 |
| D0272 | Bitewings - two radiographic images | 27 | 27 | $371.02 |
| D0230 | Intraoral - periapical each additional radiographic image | 32 | 31 | $309.90 |
| D0220 | Intraoral - periapical first radiographic image | 31 | 31 | $275.22 |
| D1206 | Topical application of fluoride varnish | 19 | 19 | $258.82 |