NPI: 1881172732 · HIGHLAND, MI 48357 · Dentist · NPI assigned 08/02/2018
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 137 | $3K |
| 2020 | 253 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 37 | 13 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 99 | 95 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 36 | 36 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 156 | 58 | $1K |
| D1120 | Prophylaxis - child | 35 | 35 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 27 | 27 | $647.27 |