GABRISH GRABOVAC, LISA
NPI: 1114977303
· CHESTERTON, IN 46304
· Pediatric Dentist
· NPI assigned 05/11/2006
$90.32
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
83 |
$90.32 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
42 |
39 |
$90.32 |
| D1206 |
Topical application of fluoride varnish |
29 |
28 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |