NPI: 1922637040 · WYCKOFF, NJ 07481 · Student in an Organized Health Care Education/Training Program · NPI assigned 04/02/2020
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 399 | $7K |
| 2023 | 339 | $7K |
| 2024 | 250 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 198 | 191 | $8K |
| D1206 | Topical application of fluoride varnish | 213 | 206 | $6K |
| D0120 | Periodic oral evaluation - established patient | 153 | 151 | $4K |
| D0272 | Bitewings - two radiographic images | 65 | 64 | $640.00 |
| D0603 | 71 | 69 | $350.00 | |
| D0601 | 24 | 24 | $120.00 | |
| D1330 | 216 | 203 | $0.00 | |
| D1310 | 48 | 46 | $0.00 |