NPI: 1588248629 · MAPLEWOOD, NJ 07040 · Student in an Organized Health Care Education/Training Program · NPI assigned 05/05/2021
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 442 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 83 | 83 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 90 | 90 | $2K |
| D0274 | Bitewings - four radiographic images | 88 | 88 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 91 | 91 | $747.06 |
| D0230 | Intraoral - periapical each additional radiographic image | 90 | 90 | $472.37 |