NPI: 1417106907 · SUMMIT, NJ 07901 · General Acute Care Hospital · NPI assigned 09/09/2008
| Authorized Official | BRENSILVER, JEFFREY (CHAIRMAN) |
| NPI Enumeration Date | 09/09/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 64 | $84.00 |
| 2019 | 94 | $1K |
| 2020 | 113 | $2K |
| 2021 | 101 | $2K |
| 2022 | 195 | $2K |
| 2023 | 159 | $2K |
| 2024 | 173 | $804.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 149 | 143 | $4K |
| D0120 | Periodic oral evaluation - established patient | 105 | 102 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 201 | 193 | $1K |
| D0140 | Limited oral evaluation - problem focused | 25 | 25 | $870.00 |
| D0210 | Intraoral - complete series of radiographic images | 17 | 15 | $600.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 16 | 16 | $450.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 40 | 38 | $192.00 |
| OP250 | 82 | 33 | $59.00 | |
| D1999 | 20 | 20 | $0.00 | |
| D1330 | 244 | 235 | $0.00 |