NPI: 1578913299 · LAPEER, MI 48446 · Dentist · NPI assigned 06/14/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 237 | $11K |
| 2019 | 672 | $18K |
| 2020 | 140 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 383 | 383 | $9K |
| D1120 | Prophylaxis - child | 214 | 214 | $8K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 45 | 29 | $5K |
| D1206 | Topical application of fluoride varnish | 233 | 233 | $5K |
| D1110 | Prophylaxis - adult | 85 | 85 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 42 | 42 | $606.70 |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $420.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 15 | 13 | $126.00 |
| D1999 | 19 | 19 | $0.00 |