NPI: 1073920997 · PEORIA, IL 61615 · General Practice Dentistry · NPI assigned 07/14/2014
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,347 | $109K |
| 2019 | 4,797 | $115K |
| 2020 | 1,560 | $38K |
| 2021 | 1,926 | $68K |
| 2022 | 4,643 | $166K |
| 2023 | 5,408 | $193K |
| 2024 | 3,778 | $126K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 5,803 | 3,213 | $334K |
| D1120 | Prophylaxis - child | 5,326 | 5,098 | $206K |
| D0120 | Periodic oral evaluation - established patient | 5,456 | 5,210 | $146K |
| D1206 | Topical application of fluoride varnish | 5,369 | 5,135 | $128K |
| D0601 | 2,965 | 2,900 | $105.00 | |
| D0602 | 1,540 | 1,513 | $50.25 |