NPI: 1346507084 · PERTH AMBOY, NJ 08861 · General Practice Dentistry · NPI assigned 04/19/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 529 | $4K |
| 2019 | 170 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 163 | 163 | $3K |
| D1120 | Prophylaxis - child | 50 | 50 | $907.20 |
| D0220 | Intraoral - periapical first radiographic image | 215 | 215 | $771.42 |
| D1110 | Prophylaxis - adult | 47 | 47 | $736.20 |
| D0230 | Intraoral - periapical each additional radiographic image | 148 | 148 | $410.61 |
| D0274 | Bitewings - four radiographic images | 45 | 45 | $327.93 |
| D0602 | 14 | 14 | $120.00 | |
| D1206 | Topical application of fluoride varnish | 17 | 17 | $105.30 |