CANCELADA, ANTOINETTE
NPI: 1942559224
· SAINT MARYS, KS 66536
· General Practice Dentistry
· NPI assigned 09/03/2012
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
66 |
$1K |
| 2019 |
92 |
$1K |
| 2020 |
32 |
$745.18 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
52 |
46 |
$988.80 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
41 |
29 |
$783.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
26 |
$531.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
36 |
32 |
$442.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$236.38 |
| D0120 |
Periodic oral evaluation - established patient |
18 |
14 |
$168.00 |