NPI: 1770776635 · JAMAICA PLAIN, MA 02130 · General Practice Dentistry · NPI assigned 08/23/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 93 | $914.76 |
| 2023 | 14 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 30 | 30 | $367.50 |
| D1120 | Prophylaxis - child | 12 | 12 | $294.00 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $138.16 |
| D0230 | Intraoral - periapical each additional radiographic image | 12 | 12 | $115.10 |
| D0601 | 40 | 40 | $0.00 |