NPI: 1770574576 · LA GRANGE, IL 60525 · General Practice Dentistry · NPI assigned 10/31/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $308.00 |
| 2019 | 124 | $4K |
| 2021 | 166 | $6K |
| 2022 | 362 | $13K |
| 2023 | 693 | $28K |
| 2024 | 710 | $28K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 878 | 878 | $41K |
| D0120 | Periodic oral evaluation - established patient | 880 | 878 | $25K |
| D7140 | Extraction, erupted tooth or exposed root | 130 | 64 | $8K |
| D0150 | Comprehensive oral evaluation - new or established patient | 166 | 163 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $85.93 |