NORTHERN MICHIGAN FAMILY DENTISTRY PLLC
NPI: 1215100987
· GAYLORD, MI 49735
· General Practice Dentistry
· NPI assigned 04/02/2008
$124K
Total Medicaid Paid
Provider Details
| Authorized Official | KOENIG, NICOLE (OFFICE MANAGER) |
| NPI Enumeration Date | 04/02/2008 |
Related Entities
Other providers sharing the same authorized official: KOENIG, NICOLE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
997 |
$33K |
| 2019 |
902 |
$28K |
| 2020 |
735 |
$22K |
| 2021 |
866 |
$27K |
| 2022 |
485 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,024 |
986 |
$39K |
| D0120 |
Periodic oral evaluation - established patient |
1,099 |
1,060 |
$28K |
| D1110 |
Prophylaxis - adult |
484 |
478 |
$23K |
| D1208 |
Topical application of fluoride, excluding varnish |
953 |
922 |
$21K |
| D0274 |
Bitewings - four radiographic images |
109 |
105 |
$4K |
| D0272 |
Bitewings - two radiographic images |
138 |
138 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
56 |
53 |
$2K |
| D0330 |
Panoramic radiographic image |
29 |
29 |
$2K |
| D1206 |
Topical application of fluoride varnish |
66 |
66 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
15 |
12 |
$997.42 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$448.00 |