NPI: 1942928049 · HIGHLAND, MI 48357 · Dental Clinic/Center · NPI assigned 08/16/2022
| Authorized Official | SCHULTZ, DANIELLE (FRONT OFFICE STAFF) |
| NPI Enumeration Date | 08/16/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 50 | $694.80 |
| 2023 | 997 | $25K |
| 2024 | 836 | $21K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 354 | 354 | $10K |
| D1206 | Topical application of fluoride varnish | 341 | 341 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 451 | 433 | $8K |
| D1120 | Prophylaxis - child | 184 | 184 | $7K |
| D1110 | Prophylaxis - adult | 135 | 135 | $7K |
| D0230 | Intraoral - periapical each additional radiographic image | 355 | 295 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 27 | 27 | $1K |
| D0272 | Bitewings - two radiographic images | 24 | 24 | $501.79 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $462.36 |