NPI: 1205849403 · SOUTH AMBOY, NJ 08879 · Dentist · NPI assigned 08/15/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 32 | $1K |
| 2019 | 93 | $2K |
| 2020 | 105 | $2K |
| 2021 | 51 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 98 | 98 | $4K |
| D0120 | Periodic oral evaluation - established patient | 41 | 41 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 44 | 44 | $579.00 |
| D0274 | Bitewings - four radiographic images | 29 | 29 | $348.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $300.00 |
| D0220 | Intraoral - periapical first radiographic image | 57 | 57 | $285.00 |