NPI: 1275762007 · PEORIA, IL 61615 · Dentist · NPI assigned 07/14/2009
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 16,510 | $428K |
| 2019 | 15,174 | $386K |
| 2020 | 7,298 | $180K |
| 2021 | 10,194 | $329K |
| 2022 | 11,996 | $439K |
| 2023 | 14,915 | $512K |
| 2024 | 12,083 | $424K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 21,976 | 11,221 | $1.16M |
| D1120 | Prophylaxis - child | 16,928 | 16,098 | $656K |
| D0120 | Periodic oral evaluation - established patient | 17,587 | 16,680 | $480K |
| D1206 | Topical application of fluoride varnish | 17,059 | 16,216 | $406K |
| D0601 | 10,535 | 10,235 | $222.75 | |
| D0602 | 3,876 | 3,800 | $120.00 | |
| D0603 | 209 | 209 | $3.00 |