COOP, STEPHANIE
NPI: 1295029841
· HOLLY, MI 48442
· General Practice Dentistry
· NPI assigned 05/31/2011
$883.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
27 |
$883.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$533.00 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$350.00 |