NPI: 1316099179 · CLIO, MI 48420 · General Practice Dentistry · NPI assigned 01/18/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 443 | $12K |
| 2019 | 508 | $15K |
| 2020 | 99 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 443 | 443 | $16K |
| D1208 | Topical application of fluoride, excluding varnish | 495 | 495 | $11K |
| D0120 | Periodic oral evaluation - established patient | 49 | 49 | $1K |
| D0210 | Intraoral - complete series of radiographic images | 13 | 13 | $948.00 |
| D0220 | Intraoral - periapical first radiographic image | 26 | 25 | $442.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 24 | 24 | $216.00 |