NPI: 1023282217 · MORTON GROVE, IL 60053 · General Practice Dentistry · NPI assigned 04/17/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 544 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 124 | 124 | $5K |
| D1206 | Topical application of fluoride varnish | 123 | 123 | $3K |
| D0120 | Periodic oral evaluation - established patient | 86 | 86 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 24 | 24 | $596.16 |
| D0272 | Bitewings - two radiographic images | 42 | 42 | $465.78 |
| D0220 | Intraoral - periapical first radiographic image | 64 | 63 | $423.04 |
| D0274 | Bitewings - four radiographic images | 19 | 19 | $378.86 |
| D0230 | Intraoral - periapical each additional radiographic image | 62 | 62 | $277.76 |