NPI: 1801505052 · COLUMBIA, MS 39429 · Dentist · NPI assigned 11/16/2022
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 176 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 46 | 43 | $2K |
| D1120 | Prophylaxis - child | 35 | 34 | $857.20 |
| D1206 | Topical application of fluoride varnish | 36 | 35 | $745.74 |
| D0220 | Intraoral - periapical first radiographic image | 45 | 41 | $409.46 |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $295.26 |