MICHAEL T. PEDERSON, DDS
NPI: 1487675005
· WALKER, MN 56484
· General Practice Dentistry
· NPI assigned 07/21/2006
Provider Details
| Authorized Official | BARKER, KATHRYN (OFFICE MANAGER) |
| NPI Enumeration Date | 07/21/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
112 |
$0.00 |
| 2019 |
16 |
$356.92 |
| 2020 |
201 |
$3K |
| 2021 |
160 |
$2K |
| 2022 |
101 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
258 |
257 |
$6K |
| D1110 |
Prophylaxis - adult |
51 |
51 |
$2K |
| D1206 |
Topical application of fluoride varnish |
108 |
108 |
$1K |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$399.85 |
| D9985 |
|
160 |
139 |
$0.00 |