NPI: 1962568782 · NAMPA, ID 83651 · General Practice Dentistry · NPI assigned 12/28/2006
| Authorized Official | MILTON, KAT (OFFICE MANAGER) |
| NPI Enumeration Date | 12/28/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,748 | $30K |
| 2019 | 1,690 | $16K |
| 2020 | 766 | $11K |
| 2021 | 631 | $8K |
| 2022 | 120 | $9.22 |
| 2023 | 84 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 573 | 572 | $55K |
| D1120 | Prophylaxis - child | 119 | 119 | $11K |
| D0120 | Periodic oral evaluation - established patient | 1,366 | 1,365 | $1K |
| D0274 | Bitewings - four radiographic images | 393 | 393 | $580.48 |
| D0220 | Intraoral - periapical first radiographic image | 919 | 911 | $77.83 |
| D1206 | Topical application of fluoride varnish | 1,230 | 1,229 | $40.65 |
| D0230 | Intraoral - periapical each additional radiographic image | 1,425 | 751 | $0.00 |
| D0272 | Bitewings - two radiographic images | 14 | 14 | $0.00 |