NPI: 1194826412 · EASTPOINTE, MI 48021 · General Practice Dentistry · NPI assigned 09/26/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 256 | $7K |
| 2019 | 381 | $10K |
| 2020 | 50 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 264 | 264 | $6K |
| D1120 | Prophylaxis - child | 120 | 120 | $5K |
| D1110 | Prophylaxis - adult | 89 | 89 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 70 | 70 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 106 | 104 | $2K |
| D0140 | Limited oral evaluation - problem focused | 12 | 12 | $437.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 26 | 26 | $216.00 |