NPI: 1649709874 · WOODHAVEN, MI 48183 · Dentist · NPI assigned 06/10/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 85 | $2K |
| 2020 | 123 | $4K |
| 2023 | 14 | $453.30 |
| 2024 | 166 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 118 | 118 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 75 | 75 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 44 | 43 | $2K |
| D0140 | Limited oral evaluation - problem focused | 30 | 28 | $975.80 |
| D0120 | Periodic oral evaluation - established patient | 42 | 40 | $760.87 |
| D0220 | Intraoral - periapical first radiographic image | 41 | 39 | $601.49 |
| D0230 | Intraoral - periapical each additional radiographic image | 38 | 30 | $353.40 |