NPI: 1376904516 · AUBURN, NY 13021 · Dentist · NPI assigned 03/16/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 287 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 71 | 71 | $3K |
| D0120 | Periodic oral evaluation - established patient | 69 | 69 | $2K |
| D0274 | Bitewings - four radiographic images | 51 | 51 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 16 | 12 | $800.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 65 | 65 | $647.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 15 | 15 | $450.00 |