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FAIRBANKS ORTHODONTIC GROUP, A PROFESSIONAL CORPORATION
FAIRBANKS ORTHODONTIC GROUP, A PROFESSIONAL CORPORATION
NPI: 1376982918
· FAIRBANKS, AK 99701
· Dental Clinic/Center
· NPI assigned 06/17/2013
$264K
Total Medicaid Paid
Provider Details
| Authorized Official | WOLLER, JESSICA (ORTHODONTIST) |
| NPI Enumeration Date | 06/17/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
36 |
$21K |
| 2019 |
139 |
$66K |
| 2020 |
58 |
$2K |
| 2021 |
51 |
$61K |
| 2022 |
82 |
$57K |
| 2023 |
81 |
$40K |
| 2024 |
40 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
271 |
220 |
$251K |
| D0330 |
Panoramic radiographic image |
73 |
72 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
42 |
40 |
$2K |
| D0340 |
|
27 |
25 |
$2K |
| D0470 |
|
30 |
28 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$846.95 |
| D0350 |
|
30 |
28 |
$0.00 |