NPI: 1396952552 · HACKENSACK, NJ 07601 · Dentist · NPI assigned 05/17/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 385 | $3K |
| 2019 | 25 | $540.00 |
| 2020 | 27 | $583.20 |
| 2021 | 12 | $259.20 |
| 2022 | 40 | $820.80 |
| 2023 | 12 | $237.60 |
| 2024 | 100 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 273 | 273 | $4K |
| D1110 | Prophylaxis - adult | 199 | 199 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 25 | 25 | $625.00 |
| D0220 | Intraoral - periapical first radiographic image | 63 | 63 | $121.80 |
| D0230 | Intraoral - periapical each additional radiographic image | 41 | 41 | $91.00 |