NPI: 1063690915 · HARBOR BEACH, MI 48441 · Dentist · NPI assigned 02/02/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 244 | $7K |
| 2019 | 227 | $7K |
| 2020 | 227 | $6K |
| 2021 | 103 | $3K |
| 2022 | 40 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 417 | 416 | $11K |
| D1120 | Prophylaxis - child | 211 | 211 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 137 | 137 | $3K |
| D0272 | Bitewings - two radiographic images | 52 | 52 | $1K |
| D1206 | Topical application of fluoride varnish | 24 | 24 | $528.00 |