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PREFERRED DENTISTRY ASSOCIATES OF WISCONSIN, L.L.C.
PREFERRED DENTISTRY ASSOCIATES OF WISCONSIN, L.L.C.
NPI: 1245543289
· EVANSTON, IL 60202
· Dentist
· NPI assigned 07/20/2010
$753K
Total Medicaid Paid
Provider Details
| Authorized Official | KARKAZIS, FRANK (MANAGER/MEMBER) |
| NPI Enumeration Date | 07/20/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
10,050 |
$188K |
| 2019 |
9,486 |
$166K |
| 2020 |
3,550 |
$41K |
| 2021 |
1,533 |
$20K |
| 2022 |
5,639 |
$75K |
| 2023 |
7,900 |
$110K |
| 2024 |
9,186 |
$152K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
9,497 |
8,622 |
$236K |
| D1351 |
Sealant - per tooth |
12,993 |
3,515 |
$230K |
| D1208 |
Topical application of fluoride, excluding varnish |
8,652 |
7,713 |
$121K |
| D0191 |
|
9,478 |
8,918 |
$99K |
| D1206 |
Topical application of fluoride varnish |
3,691 |
3,506 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
2,632 |
2,098 |
$25K |
| D1110 |
Prophylaxis - adult |
69 |
67 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
332 |
307 |
$918.84 |