NPI: 1366876260 · MT PROSPECT, IL 60056 · Dentist · NPI assigned 08/27/2013
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 49 | $1K |
| 2019 | 1,350 | $28K |
| 2020 | 994 | $2K |
| 2021 | 271 | $11K |
| 2022 | 159 | $19K |
| 2023 | 356 | $11K |
| 2024 | 324 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 1,086 | 762 | $34K |
| D0999 | Unspecified diagnostic procedure, by report | 570 | 493 | $24K |
| D0120 | Periodic oral evaluation - established patient | 792 | 549 | $11K |
| D1208 | Topical application of fluoride, excluding varnish | 814 | 579 | $2K |
| D0330 | Panoramic radiographic image | 203 | 120 | $1K |
| D2140 | 13 | 12 | $134.36 | |
| D0150 | Comprehensive oral evaluation - new or established patient | 25 | 25 | $106.15 |