NPI: 1467543504 · BATTLE CREEK, MI 49015 · Dentist · NPI assigned 09/27/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 356 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 101 | 101 | $3K |
| D1206 | Topical application of fluoride varnish | 113 | 113 | $2K |
| D0120 | Periodic oral evaluation - established patient | 90 | 90 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 40 | 40 | $629.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 12 | 12 | $108.00 |