SETAPUTRI, ANDRES
NPI: 1710393095
· SOUTHGATE, MI 48195
· General Practice Dentistry
· NPI assigned 07/07/2014
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$420.00 |
| 2019 |
74 |
$2K |
| 2020 |
126 |
$3K |
| 2021 |
201 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
143 |
143 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
164 |
164 |
$4K |
| D1206 |
Topical application of fluoride varnish |
106 |
106 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$360.00 |