NPI: 1396942918 · ADDISON, IL 60101 · General Practice Dentistry · NPI assigned 06/28/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 424 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 82 | 75 | $3K |
| D0120 | Periodic oral evaluation - established patient | 84 | 77 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 70 | 64 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 90 | 88 | $492.80 |
| D0150 | Comprehensive oral evaluation - new or established patient | 20 | 20 | $421.00 |
| D0274 | Bitewings - four radiographic images | 19 | 19 | $304.20 |
| D0230 | Intraoral - periapical each additional radiographic image | 59 | 59 | $224.20 |