NPI: 1255764767 · EATONTOWN, NJ 07724 · Dentist · NPI assigned 08/20/2013
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 176 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 29 | 29 | $1K |
| D0120 | Periodic oral evaluation - established patient | 30 | 30 | $900.00 |
| D0220 | Intraoral - periapical first radiographic image | 68 | 66 | $340.00 |
| D0274 | Bitewings - four radiographic images | 17 | 17 | $204.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 32 | 32 | $126.00 |