NPI: 1912014135 · CHICAGO, IL 60631 · Pediatric Dentist · NPI assigned 08/24/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,264 | $71K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 728 | 683 | $29K |
| D0120 | Periodic oral evaluation - established patient | 731 | 685 | $20K |
| D1206 | Topical application of fluoride varnish | 729 | 683 | $19K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 34 | 26 | $2K |
| D7140 | Extraction, erupted tooth or exposed root | 18 | 15 | $938.88 |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $112.80 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $67.20 |