NPI: 1558922765 · WYANDOTTE, MI 48192 · Dentist · NPI assigned 06/27/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 557 | $17K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 76 | 76 | $4K |
| D0274 | Bitewings - four radiographic images | 91 | 91 | $3K |
| D0330 | Panoramic radiographic image | 48 | 48 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 52 | 52 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 120 | 119 | $2K |
| D0120 | Periodic oral evaluation - established patient | 54 | 54 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 99 | 98 | $952.10 |
| D0140 | Limited oral evaluation - problem focused | 17 | 17 | $770.61 |