PRAIRIE PINES DENTAL, PLLC
NPI: 1578291803
· FOSSTON, MN 56542
· Dental Clinic/Center
· NPI assigned 08/14/2022
Provider Details
| Authorized Official | GOETSCH, KARISSA (OWNER DENTIST) |
| NPI Enumeration Date | 08/14/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
65 |
$2K |
| 2023 |
132 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
76 |
76 |
$2K |
| D1110 |
Prophylaxis - adult |
39 |
39 |
$2K |
| D1206 |
Topical application of fluoride varnish |
69 |
69 |
$2K |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$568.20 |