KYLE L. SERFOSS, DDS, PLLC
NPI: 1619155371
· CLINTON, OK 73601
· General Practice Dentistry
· NPI assigned 02/05/2008
$105K
Total Medicaid Paid
Provider Details
| Authorized Official | SERFOSS, KYLE (DENTIST) |
| NPI Enumeration Date | 02/05/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
505 |
$12K |
| 2022 |
1,969 |
$47K |
| 2023 |
1,746 |
$41K |
| 2024 |
195 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,216 |
1,216 |
$26K |
| D1120 |
Prophylaxis - child |
741 |
741 |
$22K |
| D1110 |
Prophylaxis - adult |
484 |
484 |
$22K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,232 |
1,232 |
$19K |
| D0272 |
Bitewings - two radiographic images |
649 |
649 |
$12K |
| D0330 |
Panoramic radiographic image |
93 |
93 |
$5K |