POTOCKI, MELISA
NPI: 1770996399
· MARQUETTE, MI 49855
· General Practice Dentistry
· NPI assigned 06/11/2014
$131.32
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
40 |
$131.32 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$62.37 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$47.71 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$21.24 |