PORT, SUZANNE
NPI: 1700925690
· HOLLAND, MI 49424
· Pediatric Dentist
· NPI assigned 02/06/2007
$168K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,525 |
$80K |
| 2019 |
2,285 |
$71K |
| 2020 |
628 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,585 |
1,584 |
$59K |
| D0120 |
Periodic oral evaluation - established patient |
1,677 |
1,673 |
$51K |
| D1208 |
Topical application of fluoride, excluding varnish |
821 |
819 |
$21K |
| D0272 |
Bitewings - two radiographic images |
876 |
875 |
$19K |
| D1351 |
Sealant - per tooth |
253 |
84 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
61 |
39 |
$6K |
| D1110 |
Prophylaxis - adult |
68 |
68 |
$4K |
| D0240 |
|
97 |
55 |
$2K |