NPI: 1588159172 · NOVI, MI 48375 · Dentist · NPI assigned 06/26/2018
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $72.00 |
| 2019 | 70 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 29 | 29 | $783.00 |
| D0274 | Bitewings - four radiographic images | 13 | 13 | $195.00 |
| D0220 | Intraoral - periapical first radiographic image | 27 | 27 | $162.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 13 | 13 | $135.00 |