NPI: 1760846711 · WEST NYACK, NY 10994 · Student in an Organized Health Care Education/Training Program · NPI assigned 04/06/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 682 | $4K |
| 2019 | 502 | $6K |
| 2020 | 39 | $417.20 |
| 2024 | 49 | $519.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 269 | 269 | $5K |
| D0120 | Periodic oral evaluation - established patient | 194 | 194 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 359 | 358 | $1K |
| D0274 | Bitewings - four radiographic images | 140 | 140 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 285 | 284 | $1K |
| D1120 | Prophylaxis - child | 13 | 13 | $129.60 |
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $39.00 |