NPI: 1164589107 · MAMARONECK, NY 10543 · General Practice Dentistry · NPI assigned 01/02/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 462 | $13K |
| 2020 | 12 | $193.00 |
| 2022 | 109 | $4K |
| 2024 | 40 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 191 | 191 | $9K |
| D0230 | Intraoral - periapical each additional radiographic image | 168 | 160 | $3K |
| D0274 | Bitewings - four radiographic images | 114 | 114 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 29 | 29 | $1K |
| D0120 | Periodic oral evaluation - established patient | 48 | 48 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 42 | 42 | $1K |
| D1120 | Prophylaxis - child | 13 | 13 | $559.00 |
| D0220 | Intraoral - periapical first radiographic image | 18 | 18 | $378.00 |