NPI: 1104597533 · BLOOMFIELD, NJ 07003 · General Practice Dentistry · NPI assigned 09/24/2021
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 337 | $7K |
| 2023 | 189 | $2K |
| 2024 | 879 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 210 | 210 | $5K |
| D1120 | Prophylaxis - child | 89 | 89 | $4K |
| D1110 | Prophylaxis - adult | 81 | 81 | $4K |
| D1206 | Topical application of fluoride varnish | 107 | 107 | $3K |
| D9920 | 31 | 30 | $750.00 | |
| D0220 | Intraoral - periapical first radiographic image | 118 | 116 | $555.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 18 | 18 | $425.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 85 | 85 | $237.00 |
| D0603 | 21 | 21 | $160.00 | |
| D0602 | 14 | 14 | $120.00 | |
| D0601 | 13 | 13 | $100.00 | |
| D1999 | 404 | 361 | $0.00 | |
| D1310 | 76 | 76 | $0.00 | |
| D1330 | 138 | 138 | $0.00 |