NPI: 1689943722 · HARVEY, IL 60426 · General Practice Dentistry · NPI assigned 12/19/2011
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 47 | $729.19 |
| 2020 | 145 | $8K |
| 2021 | 30 | $861.12 |
| 2023 | 48 | $0.00 |
| 2024 | 29 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 102 | 82 | $5K |
| D0120 | Periodic oral evaluation - established patient | 113 | 105 | $3K |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $530.75 |
| D0220 | Intraoral - periapical first radiographic image | 16 | 16 | $424.60 |
| D1120 | Prophylaxis - child | 30 | 29 | $107.64 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $106.15 |
| D0140 | Limited oral evaluation - problem focused | 13 | 13 | $0.00 |