NPI: 1033586276 · HANOVER PARK, IL 60133 · Dentist · NPI assigned 08/24/2015
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 403 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 106 | 105 | $4K |
| D0120 | Periodic oral evaluation - established patient | 97 | 96 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 61 | 60 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 57 | 56 | $319.20 |
| D0274 | Bitewings - four radiographic images | 15 | 15 | $253.50 |
| D0230 | Intraoral - periapical each additional radiographic image | 51 | 50 | $193.80 |
| D0272 | Bitewings - two radiographic images | 16 | 16 | $150.40 |