NPI: 1780243063 · CHARLES CITY, IA 50616 · General Practice Dentistry · NPI assigned 06/10/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 540 | $12K |
| 2020 | 545 | $12K |
| 2021 | 208 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 237 | 225 | $8K |
| D1206 | Topical application of fluoride varnish | 335 | 328 | $5K |
| D0120 | Periodic oral evaluation - established patient | 258 | 254 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 201 | 188 | $5K |
| D0330 | Panoramic radiographic image | 46 | 46 | $2K |
| D0274 | Bitewings - four radiographic images | 85 | 80 | $2K |
| D1120 | Prophylaxis - child | 71 | 69 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 60 | 55 | $841.50 |