NPI: 1912434523 · HONOLULU, HI 96813 · Pediatric Dentist · NPI assigned 05/12/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 205 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 74 | 74 | $2K |
| D1120 | Prophylaxis - child | 33 | 33 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 73 | 73 | $1K |
| D1110 | Prophylaxis - adult | 13 | 13 | $754.00 |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $204.00 |