NPI: 1306835517 · MT PROSPECT, IL 60056 · Dentist · NPI assigned 10/19/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 909 | $25K |
| 2019 | 954 | $29K |
| 2020 | 638 | $20K |
| 2021 | 626 | $20K |
| 2022 | 962 | $27K |
| 2023 | 933 | $29K |
| 2024 | 924 | $28K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 1,822 | 1,784 | $75K |
| D0120 | Periodic oral evaluation - established patient | 1,786 | 1,746 | $51K |
| D1206 | Topical application of fluoride varnish | 1,795 | 1,759 | $47K |
| D0274 | Bitewings - four radiographic images | 109 | 106 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 243 | 237 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 191 | 187 | $1K |