NPI: 1811058647 · GLENDALE, NY 11385 · General Practice Dentistry · NPI assigned 12/13/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 72 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 17 | 17 | $678.30 |
| D0274 | Bitewings - four radiographic images | 15 | 15 | $300.20 |
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $279.20 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $98.60 |
| D0230 | Intraoral - periapical each additional radiographic image | 14 | 14 | $79.30 |