JP DENTAL - KOKOMO LLC
NPI: 1336592849
· KOKOMO, IN 46902
· General Practice Dentistry
· NPI assigned 07/20/2016
$214.25
Total Medicaid Paid
Provider Details
| Authorized Official | PASICZNYK, JOHN (MANAGER) |
| NPI Enumeration Date | 07/20/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
38 |
$214.25 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
15 |
12 |
$143.25 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
23 |
13 |
$71.00 |