NPI: 1730247008 · OAK PARK, MI 48237 · General Practice Dentistry · NPI assigned 12/05/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 276 | $7K |
| 2019 | 272 | $7K |
| 2020 | 334 | $7K |
| 2021 | 427 | $10K |
| 2022 | 209 | $6K |
| 2023 | 120 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 530 | 529 | $21K |
| D0120 | Periodic oral evaluation - established patient | 627 | 625 | $14K |
| D0274 | Bitewings - four radiographic images | 105 | 105 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 209 | 207 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 48 | 48 | $1K |
| D1120 | Prophylaxis - child | 24 | 24 | $878.54 |
| D0230 | Intraoral - periapical each additional radiographic image | 83 | 78 | $468.71 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $404.78 |