NPI: 1972536761 · CARROLLTON, IL 62016 · General Practice Dentistry · NPI assigned 07/08/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 138 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 52 | 52 | $2K |
| D0120 | Periodic oral evaluation - established patient | 53 | 53 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 21 | 13 | $647.85 |
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $312.00 |