NPI: 1821210915
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 77 | $717.00 |
| 2019 | 39 | $2K |
| 2020 | 526 | $14K |
| 2021 | 13 | $156.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 117 | 117 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 282 | 256 | $3K |
| D5750 | 14 | 14 | $3K | |
| D1110 | Prophylaxis - adult | 24 | 24 | $2K |
| D9110 | 22 | 19 | $1K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 20 | 12 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 158 | 103 | $1K |
| D2920 | 18 | 15 | $756.00 |