KOOISTRA, RALPH
NPI: 1528193745
· GAYLORD, MI 49735
· General Practice Dentistry
· NPI assigned 02/21/2007
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
95 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
46 |
46 |
$1K |
| D1120 |
Prophylaxis - child |
18 |
17 |
$560.87 |
| D1206 |
Topical application of fluoride varnish |
18 |
18 |
$400.54 |
| D0272 |
Bitewings - two radiographic images |
13 |
12 |
$250.00 |