TSESIS, MIKHAIL
NPI: 1376950758
· HOLYOKE, MA 01040
· General Practice Dentistry
· NPI assigned 07/17/2014
$438.40
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
113 |
$438.40 |
| 2021 |
22 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
14 |
14 |
$323.40 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$115.00 |
| D1999 |
|
107 |
92 |
$0.00 |