NPI: 1821009929 · HIGHLAND, MI 48357 · General Practice Dentistry · NPI assigned 08/11/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 76 | $1K |
| 2019 | 13 | $348.35 |
| 2020 | 72 | $1K |
| 2021 | 386 | $13K |
| 2022 | 375 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 132 | 132 | $5K |
| D0120 | Periodic oral evaluation - established patient | 188 | 188 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 36 | 12 | $5K |
| D1206 | Topical application of fluoride varnish | 192 | 192 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 232 | 228 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 130 | 113 | $955.73 |
| D1110 | Prophylaxis - adult | 12 | 12 | $592.28 |