NPI: 1033223052 · HOUGHTON LAKE, MI 48629 · General Practice Dentistry · NPI assigned 08/18/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 746 | $20K |
| 2019 | 832 | $22K |
| 2020 | 136 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 469 | 469 | $16K |
| D0120 | Periodic oral evaluation - established patient | 545 | 545 | $13K |
| D1208 | Topical application of fluoride, excluding varnish | 541 | 541 | $11K |
| D1110 | Prophylaxis - adult | 82 | 82 | $4K |
| D0274 | Bitewings - four radiographic images | 27 | 27 | $900.00 |
| D0272 | Bitewings - two radiographic images | 38 | 38 | $850.00 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $153.00 |