NPI: 1467148858 · RANDOLPH, NJ 07869 · General Practice Dentistry · NPI assigned 04/18/2023
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 226 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 53 | 53 | $2K |
| D0120 | Periodic oral evaluation - established patient | 81 | 81 | $2K |
| D1206 | Topical application of fluoride varnish | 41 | 41 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 36 | 36 | $900.00 |
| D1120 | Prophylaxis - child | 15 | 15 | $675.00 |