LAKE STATE DENTAL PLLC
NPI: 1942986476
· STURGIS, MI 49091
· Dental Clinic/Center
· NPI assigned 06/27/2023
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
38 |
$1K |
| 2024 |
111 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
67 |
67 |
$2K |
| D1206 |
Topical application of fluoride varnish |
65 |
65 |
$2K |
| D1120 |
Prophylaxis - child |
17 |
17 |
$735.25 |