NPI: 1831264985 · TUSTIN, CA 92780 · Dentist · NPI assigned 11/22/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,849 | $29K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 255 | 255 | $8K |
| D1120 | Prophylaxis - child | 156 | 156 | $5K |
| D1110 | Prophylaxis - adult | 65 | 65 | $4K |
| D0274 | Bitewings - four radiographic images | 160 | 160 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 305 | 304 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 698 | 223 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 198 | 177 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $420.00 |