NPI: 1972519056 · WELLESLEY, MA 02482 · Dentist · NPI assigned 07/31/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 372 | $14K |
| 2019 | 32 | $1K |
| 2020 | 12 | $0.00 |
| 2023 | 272 | $12K |
| 2024 | 296 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 518 | 503 | $26K |
| D1206 | Topical application of fluoride varnish | 97 | 97 | $4K |
| D0120 | Periodic oral evaluation - established patient | 161 | 161 | $4K |
| D0140 | Limited oral evaluation - problem focused | 60 | 53 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 26 | 25 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 58 | 55 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 50 | 42 | $640.00 |
| D9410 | 14 | 13 | $546.00 |