NPI: 1902210297 · FOREST, MS 39074 · General Practice Dentistry · NPI assigned 06/16/2014
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 7,896 | $154K |
| 2019 | 5,156 | $103K |
| 2020 | 1,166 | $23K |
| 2021 | 647 | $15K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 4,706 | 1,167 | $97K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2,004 | 1,663 | $64K |
| D1120 | Prophylaxis - child | 2,716 | 2,054 | $45K |
| D1206 | Topical application of fluoride varnish | 2,500 | 2,119 | $43K |
| D0272 | Bitewings - two radiographic images | 2,291 | 1,734 | $27K |
| D0140 | Limited oral evaluation - problem focused | 454 | 450 | $17K |
| D0120 | Periodic oral evaluation - established patient | 20 | 20 | $515.60 |
| D1208 | Topical application of fluoride, excluding varnish | 174 | 39 | $0.00 |