NPI: 1295265031 · CLOSTER, NJ 07624 · General Practice Dentistry · NPI assigned 06/14/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 129 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 42 | 42 | $2K |
| D1206 | Topical application of fluoride varnish | 44 | 44 | $1K |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $350.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 13 | 13 | $96.00 |
| D0220 | Intraoral - periapical first radiographic image | 16 | 16 | $80.00 |