KIM, MI
NPI: 1528176252
· LAWRENCEVILLE, GA 30043
· General Practice Dentistry
· NPI assigned 08/25/2006
$755.54
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
36 |
$755.54 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$393.36 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$267.30 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$94.88 |