COLONIAL HEIGHTS DENTAL CARE, INC.
NPI: 1003352931
· COLONIAL HEIGHTS, VA 23834
· General Practice Dentistry
· NPI assigned 01/17/2017
$942.00
Total Medicaid Paid
Provider Details
| Authorized Official | HAGAR, BASIONY (DOCTOR) |
| NPI Enumeration Date | 01/17/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
24 |
$942.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$566.28 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$375.72 |