AHLGRIM, STEPHEN
NPI: 1376662239
· WATERTOWN, NY 13601
· General Practice Dentistry
· NPI assigned 03/29/2007
$118K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
276 |
$10K |
| 2019 |
360 |
$14K |
| 2020 |
532 |
$20K |
| 2021 |
761 |
$29K |
| 2022 |
527 |
$21K |
| 2023 |
430 |
$16K |
| 2024 |
204 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
882 |
882 |
$61K |
| D0120 |
Periodic oral evaluation - established patient |
900 |
900 |
$31K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,068 |
1,068 |
$18K |
| D0274 |
Bitewings - four radiographic images |
199 |
199 |
$7K |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$672.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$540.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$418.20 |