NPI: 1689022410 · STANDISH, MI 48658 · Dentist · NPI assigned 06/02/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 90 | $5K |
| 2022 | 111 | $3K |
| 2023 | 121 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 85 | 85 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 23 | 13 | $3K |
| D0120 | Periodic oral evaluation - established patient | 101 | 101 | $2K |
| D1206 | Topical application of fluoride varnish | 84 | 84 | $2K |
| D1110 | Prophylaxis - adult | 16 | 16 | $840.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 13 | $559.00 |