NPI: 1780970327 · LIBERTY, MO 64068 · Dentist · NPI assigned 06/22/2011
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 228 | $3K |
| 2021 | 180 | $2K |
| 2022 | 77 | $728.08 |
| 2023 | 42 | $2K |
| 2024 | 87 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 410 | 223 | $5K |
| D0274 | Bitewings - four radiographic images | 43 | 40 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 77 | 68 | $2K |
| D0330 | Panoramic radiographic image | 19 | 17 | $587.52 |
| D0230 | Intraoral - periapical each additional radiographic image | 39 | 12 | $311.61 |
| D0140 | Limited oral evaluation - problem focused | 12 | 12 | $239.80 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $58.00 |