NPI: 1720256746 · BENTON HARBOR, MI 49022 · Dentist · NPI assigned 02/12/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 477 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 132 | 132 | $5K |
| D1206 | Topical application of fluoride varnish | 143 | 143 | $4K |
| D0120 | Periodic oral evaluation - established patient | 78 | 78 | $2K |
| D0274 | Bitewings - four radiographic images | 33 | 33 | $1K |
| D1110 | Prophylaxis - adult | 21 | 21 | $1K |
| D0191 | 70 | 70 | $956.96 |