KELLY KLONTZ DDS,PLLC
NPI: 1003290545
· OKLAHOMA CITY, OK 73159
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 07/15/2015
$612K
Total Medicaid Paid
Provider Details
| Authorized Official | KLONTZ, KELLY (OWNER) |
| NPI Enumeration Date | 07/15/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
147 |
$73K |
| 2019 |
230 |
$40K |
| 2020 |
241 |
$76K |
| 2021 |
190 |
$106K |
| 2022 |
406 |
$148K |
| 2023 |
246 |
$137K |
| 2024 |
54 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
456 |
456 |
$561K |
| D9310 |
|
787 |
777 |
$38K |
| D0340 |
|
152 |
152 |
$9K |
| D0350 |
|
86 |
86 |
$3K |
| D0470 |
|
19 |
19 |
$689.70 |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$682.78 |