NPI: 1497359954 · FEASTERVILLE TREVOSE, PA 19053 · Dentist · NPI assigned 11/25/2020
| Authorized Official | FROLOV, IRINA (OWNER/DENTIST) |
| NPI Enumeration Date | 11/25/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 215 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 90 | 88 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 25 | 25 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 29 | 29 | $560.00 |
| D0120 | Periodic oral evaluation - established patient | 35 | 35 | $500.00 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $308.00 |
| D1330 | 12 | 12 | $121.88 | |
| D1310 | 12 | 12 | $119.57 |