PEDERSON, ROBERT
NPI: 1063529808
· MONDOVI, WI 54755
· General Practice Dentistry
· NPI assigned 08/25/2006
$149K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,461 |
$25K |
| 2019 |
1,209 |
$21K |
| 2020 |
750 |
$13K |
| 2021 |
1,035 |
$18K |
| 2022 |
1,067 |
$27K |
| 2023 |
1,044 |
$25K |
| 2024 |
792 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,428 |
2,372 |
$73K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,805 |
2,732 |
$39K |
| D0120 |
Periodic oral evaluation - established patient |
1,514 |
1,477 |
$24K |
| D0274 |
Bitewings - four radiographic images |
371 |
363 |
$7K |
| D1120 |
Prophylaxis - child |
176 |
174 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
27 |
27 |
$563.71 |
| D0272 |
Bitewings - two radiographic images |
24 |
24 |
$318.36 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$247.47 |