NPI: 1952713026 · HUGO, MN 55038 · General Practice Dentistry · NPI assigned 05/23/2014
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 232 | $920.38 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30 | 30 | $374.99 |
| D0150 | Comprehensive oral evaluation - new or established patient | 43 | 43 | $192.44 |
| D0274 | Bitewings - four radiographic images | 28 | 28 | $177.30 |
| D0230 | Intraoral - periapical each additional radiographic image | 60 | 41 | $94.64 |
| D0220 | Intraoral - periapical first radiographic image | 44 | 44 | $81.01 |
| D1206 | Topical application of fluoride varnish | 13 | 13 | $0.00 |
| D1120 | Prophylaxis - child | 14 | 14 | $0.00 |