PHUONGDAO DMD LLC
NPI: 1003176512
· EVERETT, MA 02149
· General Practice Dentistry
· NPI assigned 05/18/2012
$167K
Total Medicaid Paid
Provider Details
| Authorized Official | DAO, PHUONG (OWNER) |
| NPI Enumeration Date | 05/18/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
759 |
$29K |
| 2019 |
688 |
$26K |
| 2020 |
393 |
$14K |
| 2021 |
681 |
$25K |
| 2022 |
645 |
$25K |
| 2023 |
683 |
$26K |
| 2024 |
508 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,090 |
2,063 |
$113K |
| D0120 |
Periodic oral evaluation - established patient |
2,132 |
2,105 |
$48K |
| D1208 |
Topical application of fluoride, excluding varnish |
79 |
78 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
24 |
12 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
12 |
$1K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$612.00 |