COUNTY OF OTTAWA
NPI: 1871780080
· HOLLAND, MI 49424
· Public Health or Welfare Agency
· NPI assigned 10/02/2007
$221K
Total Medicaid Paid
Provider Details
| Authorized Official | STEFANOVSKY, LISA (HEALTH DIRECTOR) |
| NPI Enumeration Date | 10/02/2007 |
Related Entities
Other providers sharing the same authorized official: STEFANOVSKY, LISA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
40 |
$216.45 |
| 2019 |
226 |
$5K |
| 2020 |
376 |
$7K |
| 2021 |
1,421 |
$38K |
| 2022 |
2,480 |
$63K |
| 2023 |
2,367 |
$64K |
| 2024 |
1,597 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
3,276 |
612 |
$82K |
| D1120 |
Prophylaxis - child |
956 |
955 |
$37K |
| D1206 |
Topical application of fluoride varnish |
1,757 |
1,748 |
$36K |
| D0191 |
|
1,471 |
1,467 |
$27K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
116 |
72 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
258 |
258 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
304 |
303 |
$8K |
| D0272 |
Bitewings - two radiographic images |
355 |
354 |
$8K |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$287.30 |