Dental
Dawn Ag Kulongowski, DDS, PC
Dawn Ag Kulongowski, DDS, PC was paid $9K by Medicaid between Jul 2020 and Oct 2024, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 55% of everything it billed.
33Billing provider infoDAWN AG KULONGOWSKI, DDS, PC
HOLLY, MI 48442
HOLLY, MI 48442
33aNPI1649664269assigned 03/20/2015
33bProvider typeGeneral Practice Dentistry
28Total paid$9K
24GClaims370
24DCodes billed6
24AFirst – last monthJul 2020 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Michigan
Rank by total paid#865 of 1,554
Median peer was paid$15K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2020 | 42 | $732.00 | |
| 2021 | 103 | $3K | |
| 2022 | 49 | $1K | |
| 2023 | 69 | $2K | |
| 2024incomplete | 107 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 55% | 200 | 200 | $5K |
| D1110 | Prophylaxis - adult | 15% | 29 | 29 | $1K |
| D1206 | Topical application of fluoride varnish | 12% | 49 | 49 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 9.6% | 50 | 49 | $894.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 5.7% | 13 | 13 | $533.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 3.2% | 29 | 25 | $295.00 |
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.
From NPPES
Who's on the registration
Authorized officialWAGNER, CHRIS (OFFICE MANAGER)