NPI: 1508993288 · OAK PARK, MI 48237 · General Practice Dentistry · NPI assigned 02/28/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 301 | $7K |
| 2019 | 36 | $938.00 |
| 2020 | 82 | $2K |
| 2021 | 36 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 156 | 156 | $4K |
| D1110 | Prophylaxis - adult | 52 | 52 | $2K |
| D1206 | Topical application of fluoride varnish | 70 | 70 | $2K |
| D0274 | Bitewings - four radiographic images | 29 | 29 | $928.00 |
| D0220 | Intraoral - periapical first radiographic image | 58 | 58 | $881.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 64 | 58 | $501.00 |
| D1120 | Prophylaxis - child | 13 | 13 | $473.69 |
| D9996 | 13 | 12 | $0.00 |