KODIAK ISLAND FAMILY DENTISTRY
NPI: 1811568900
· KODIAK, AK 99615
· Dental Clinic/Center
· NPI assigned 07/08/2021
Provider Details
| Authorized Official | LEIVA, TABITHA (OFFICE MANAGER) |
| NPI Enumeration Date | 07/08/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,097 |
$27K |
| 2022 |
1,026 |
$34K |
| 2023 |
192 |
$7K |
| 2024 |
165 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
1,025 |
750 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
535 |
393 |
$18K |
| D1120 |
Prophylaxis - child |
303 |
244 |
$15K |
| D1110 |
Prophylaxis - adult |
165 |
113 |
$8K |
| D4910 |
|
71 |
41 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
154 |
99 |
$2K |
| D0274 |
Bitewings - four radiographic images |
69 |
42 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
52 |
26 |
$2K |
| D1351 |
Sealant - per tooth |
50 |
12 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
56 |
28 |
$616.05 |