NPI: 1275063042 · LAWRENCE, MI 49064 · General Practice Dentistry · NPI assigned 06/14/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 269 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 59 | 59 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16 | 13 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 22 | 14 | $2K |
| D0120 | Periodic oral evaluation - established patient | 68 | 68 | $2K |
| D1206 | Topical application of fluoride varnish | 68 | 68 | $2K |
| D0274 | Bitewings - four radiographic images | 24 | 24 | $724.81 |
| D1110 | Prophylaxis - adult | 12 | 12 | $582.00 |