NPI: 1760921118 · NORTHPORT, NY 11768 · Student in an Organized Health Care Education/Training Program · NPI assigned 02/17/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 681 | $14K |
| 2020 | 16 | $158.72 |
| 2023 | 41 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 183 | 183 | $7K |
| D0120 | Periodic oral evaluation - established patient | 184 | 184 | $4K |
| D0274 | Bitewings - four radiographic images | 132 | 132 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 145 | 145 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 28 | 28 | $507.72 |
| D0210 | Intraoral - complete series of radiographic images | 17 | 17 | $435.27 |
| D0230 | Intraoral - periapical each additional radiographic image | 49 | 49 | $290.27 |