NPI: 1003954819 · MARION, IL 62959 · General Practice Dentistry · NPI assigned 02/02/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 2,226 | $70K |
| 2024 | 731 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 648 | 648 | $28K |
| D0120 | Periodic oral evaluation - established patient | 674 | 674 | $20K |
| D1351 | Sealant - per tooth | 243 | 139 | $19K |
| D1206 | Topical application of fluoride varnish | 651 | 651 | $18K |
| D0601 | 374 | 374 | $5K | |
| D0602 | 129 | 129 | $2K | |
| D0603 | 73 | 73 | $802.50 | |
| D1999 | 165 | 165 | $0.00 |