NPI: 1912255803 · AIEA, HI 96701 · Dentist · NPI assigned 08/27/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 219 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 63 | 57 | $2K |
| D1120 | Prophylaxis - child | 39 | 35 | $1K |
| D1206 | Topical application of fluoride varnish | 55 | 51 | $1K |
| D0272 | Bitewings - two radiographic images | 30 | 30 | $695.95 |
| D1110 | Prophylaxis - adult | 14 | 14 | $678.30 |
| D0603 | 18 | 17 | $0.18 |