NPI: 1932376910 · IOLA, KS 66749 · General Practice Dentistry · NPI assigned 05/09/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 982 | $60K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 525 | 520 | $28K |
| D1120 | Prophylaxis - child | 140 | 139 | $12K |
| D1110 | Prophylaxis - adult | 93 | 92 | $8K |
| D0330 | Panoramic radiographic image | 47 | 46 | $5K |
| D0140 | Limited oral evaluation - problem focused | 55 | 55 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 41 | 40 | $2K |
| D0120 | Periodic oral evaluation - established patient | 39 | 37 | $253.00 |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $126.50 |
| D0191 | 14 | 14 | $0.00 | |
| D0220 | Intraoral - periapical first radiographic image | 14 | 12 | $0.00 |