NIMKEE DENTAL SAGINAW CHIPPEWA INDIAN TRIBE
NPI: 1417039843
· MT PLEASANT, MI 48858
· Dentist
· NPI assigned 10/19/2006
$219K
Total Medicaid Paid
Provider Details
| Authorized Official | FOX, KARMEN (EXECUTIVE HEALTH DIRECTOR) |
| NPI Enumeration Date | 10/19/2006 |
Related Entities
Other providers sharing the same authorized official: FOX, KARMEN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
255 |
$20K |
| 2019 |
346 |
$30K |
| 2020 |
441 |
$16K |
| 2021 |
302 |
$23K |
| 2022 |
452 |
$71K |
| 2023 |
341 |
$44K |
| 2024 |
166 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
388 |
388 |
$125K |
| D0120 |
Periodic oral evaluation - established patient |
497 |
496 |
$57K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
70 |
70 |
$18K |
| D1206 |
Topical application of fluoride varnish |
486 |
486 |
$10K |
| D1120 |
Prophylaxis - child |
201 |
200 |
$7K |
| D0274 |
Bitewings - four radiographic images |
181 |
181 |
$2K |
| D0330 |
Panoramic radiographic image |
28 |
28 |
$469.44 |
| D0220 |
Intraoral - periapical first radiographic image |
67 |
64 |
$204.00 |
| D1999 |
|
385 |
336 |
$0.00 |