NPI: 1942369228 · KALKASKA, MI 49646 · General Practice Dentistry · NPI assigned 12/06/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 276 | $8K |
| 2019 | 53 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 78 | 78 | $3K |
| D0120 | Periodic oral evaluation - established patient | 98 | 97 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 93 | 93 | $2K |
| D1110 | Prophylaxis - adult | 34 | 34 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 14 | $516.00 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $187.00 |