NPI: 1639370448 · WILLIAMSVILLE, NY 14221 · Dentist · NPI assigned 05/30/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 107 | $4K |
| 2020 | 260 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 103 | 61 | $6K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 57 | 38 | $5K |
| D1110 | Prophylaxis - adult | 57 | 57 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 83 | 83 | $2K |
| D0274 | Bitewings - four radiographic images | 50 | 50 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 17 | 17 | $220.50 |