NPI: 1851563928 · GWINN, MI 49841 · Dentist · NPI assigned 03/29/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 476 | $13K |
| 2019 | 420 | $11K |
| 2020 | 61 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 370 | 370 | $10K |
| D1120 | Prophylaxis - child | 223 | 223 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 326 | 326 | $7K |
| D0274 | Bitewings - four radiographic images | 26 | 26 | $864.00 |
| D1110 | Prophylaxis - adult | 12 | 12 | $594.00 |