NPI: 1942441563 · FLORISSANT, MO 63033 · General Practice Dentistry · NPI assigned 03/11/2009
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 69 | $652.00 |
| 2021 | 275 | $17K |
| 2022 | 128 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 102 | 82 | $9K |
| D0140 | Limited oral evaluation - problem focused | 92 | 84 | $9K |
| D7140 | Extraction, erupted tooth or exposed root | 46 | 44 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 34 | 30 | $4K |
| D0120 | Periodic oral evaluation - established patient | 82 | 49 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 12 | 12 | $1K |
| D1206 | Topical application of fluoride varnish | 104 | 44 | $416.00 |