Kooistra, Ralph

Kooistra, Ralph was paid $2K by Medicaid between Jan 2018 and Mar 2018, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 47% of everything it billed.

33Billing provider infoKOOISTRA, RALPH
GAYLORD, MI 49735

33aNPI1528193745assigned 02/21/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$2K

24GClaims95

24DCodes billed4

24AFirst – last monthJan 2018 – Mar 2018

Compared with peers

Next to other General Practice Dentistry providers in Michigan

Rank by total paid#1,145 of 1,554

Median peer was paid$15K

This provider vs. median0.2×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	95	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	47%	46	46	$1K
D1120	Dental cleaning, childProphylaxis - child	25%	18	17	$560.87
D1206	Topical application of fluoride varnish	18%	18	18	$400.54
D0272	Bitewings - two radiographic images	11%	13	12	$250.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.