NPI: 1730219957 · PEORIA, IL 61614 · Dentist · NPI assigned 03/06/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 8,084 | $201K |
| 2019 | 9,227 | $234K |
| 2020 | 1,725 | $47K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 3,742 | 3,678 | $144K |
| D1351 | Sealant - per tooth | 2,675 | 1,322 | $124K |
| D0120 | Periodic oral evaluation - established patient | 4,754 | 4,668 | $123K |
| D1206 | Topical application of fluoride varnish | 3,798 | 3,731 | $92K |
| D0602 | 987 | 973 | $0.00 | |
| D0601 | 2,576 | 2,559 | $0.00 | |
| D0603 | 504 | 501 | $0.00 |