ADISKA, GARY
NPI: 1205249653
· STOCKBRIDGE, MI 49285
· Dentist
· NPI assigned 06/03/2014
$720.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
27 |
$720.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$420.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$300.00 |