NPI: 1417242736 · POMONA, NY 10970 · General Practice Dentistry · NPI assigned 06/15/2011
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 103 | $2K |
| 2021 | 138 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 77 | 77 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 67 | 67 | $740.79 |
| D0274 | Bitewings - four radiographic images | 28 | 28 | $607.32 |
| D0230 | Intraoral - periapical each additional radiographic image | 28 | 28 | $293.44 |
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $260.28 |
| D0210 | Intraoral - complete series of radiographic images | 28 | 28 | $20.72 |