NPI: 1992991152 · DANVILLE, IN 46122 · Dentist · NPI assigned 09/21/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 396 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 94 | 29 | $3K |
| D1110 | Prophylaxis - adult | 65 | 38 | $2K |
| D0120 | Periodic oral evaluation - established patient | 87 | 54 | $1K |
| D1120 | Prophylaxis - child | 38 | 26 | $897.00 |
| D1206 | Topical application of fluoride varnish | 51 | 34 | $845.50 |
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 12 | $326.60 |
| D1999 | 37 | 16 | $0.00 |