NPI: 1801940721 · LUMBERTON, NJ 08048 · Dentist · NPI assigned 01/22/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 178 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 57 | 57 | $2K |
| D1120 | Prophylaxis - child | 32 | 32 | $704.00 |
| D0274 | Bitewings - four radiographic images | 28 | 28 | $420.00 |
| D0220 | Intraoral - periapical first radiographic image | 33 | 33 | $198.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 28 | 28 | $159.00 |