NPI: 1972164317 · WEST CHESTER, OH 45069 · Dentist · NPI assigned 06/26/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 201 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0274 | Bitewings - four radiographic images | 30 | 30 | $600.00 |
| D0120 | Periodic oral evaluation - established patient | 31 | 31 | $529.48 |
| D0140 | Limited oral evaluation - problem focused | 20 | 20 | $451.60 |
| D0150 | Comprehensive oral evaluation - new or established patient | 15 | 15 | $395.25 |
| D0220 | Intraoral - periapical first radiographic image | 56 | 56 | $280.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 49 | 32 | $245.00 |