NPI: 1780750430 · VIRDEN, IL 62690 · Dentist · NPI assigned 11/27/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 116 | $3K |
| 2019 | 488 | $12K |
| 2021 | 169 | $6K |
| 2022 | 294 | $9K |
| 2023 | 121 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1351 | Sealant - per tooth | 197 | 91 | $9K |
| D1120 | Prophylaxis - child | 258 | 252 | $9K |
| D0120 | Periodic oral evaluation - established patient | 262 | 254 | $7K |
| D1206 | Topical application of fluoride varnish | 256 | 250 | $6K |
| D0140 | Limited oral evaluation - problem focused | 53 | 52 | $917.76 |
| D0601 | 81 | 81 | $451.96 | |
| D0602 | 51 | 51 | $255.05 | |
| D0603 | 17 | 17 | $168.78 | |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $85.93 |