NPI: 1700197704 · TROY, MI 48084 · General Practice Dentistry · NPI assigned 06/24/2010
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 53 | $1K |
| 2020 | 40 | $130.00 |
| 2021 | 21 | $0.00 |
| 2022 | 162 | $4K |
| 2023 | 420 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | 322 | 136 | $12K |
| D0274 | Bitewings - four radiographic images | 121 | 118 | $2K |
| D0330 | Panoramic radiographic image | 95 | 95 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 53 | 52 | $763.80 |
| D0120 | Periodic oral evaluation - established patient | 30 | 30 | $672.00 |
| D0210 | Intraoral - complete series of radiographic images | 14 | 14 | $156.40 |
| D1206 | Topical application of fluoride varnish | 14 | 14 | $130.00 |
| D1310 | 47 | 38 | $0.00 |