NPI: 1336137645 · FREMONT, MI 49412 · Dentist · NPI assigned 10/11/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 648 | $20K |
| 2019 | 756 | $23K |
| 2020 | 257 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 625 | 625 | $15K |
| D1110 | Prophylaxis - adult | 307 | 307 | $14K |
| D1120 | Prophylaxis - child | 324 | 324 | $12K |
| D1206 | Topical application of fluoride varnish | 362 | 362 | $8K |
| D0272 | Bitewings - two radiographic images | 28 | 28 | $668.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 15 | 15 | $618.00 |