NPI: 1770709057 · PALM HARBOR, FL 34684 · General Practice Dentistry · NPI assigned 04/17/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 124 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 13 | 13 | $413.15 |
| D1206 | Topical application of fluoride varnish | 23 | 23 | $359.70 |
| D0120 | Periodic oral evaluation - established patient | 17 | 17 | $356.64 |
| D1330 | 19 | 19 | $169.48 | |
| D0230 | Intraoral - periapical each additional radiographic image | 31 | 20 | $133.80 |
| D0220 | Intraoral - periapical first radiographic image | 21 | 21 | $119.00 |