NPI: 1437417334 · WOODHAVEN, MI 48183 · General Practice Dentistry · NPI assigned 04/27/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 542 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 83 | 83 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 130 | 130 | $3K |
| D0120 | Periodic oral evaluation - established patient | 104 | 104 | $3K |
| D1110 | Prophylaxis - adult | 34 | 34 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 97 | 97 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 77 | 77 | $675.00 |
| D0272 | Bitewings - two radiographic images | 17 | 17 | $425.00 |