NPI: 1780800391 · CHICAGO HEIGHTS, IL 60411 · Dentist · NPI assigned 04/18/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 119 | $4K |
| 2023 | 474 | $21K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D4341 | 51 | 24 | $7K | |
| D1120 | Prophylaxis - child | 129 | 129 | $5K |
| D0120 | Periodic oral evaluation - established patient | 148 | 147 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 123 | 123 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 52 | 33 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 48 | 48 | $1K |
| D0330 | Panoramic radiographic image | 28 | 27 | $756.00 |
| D0274 | Bitewings - four radiographic images | 14 | 14 | $254.32 |