SONRISAS
NPI: 1003397761
· PHOENIX, AZ 85033
· Dentist
· NPI assigned 08/22/2018
$228.61
Total Medicaid Paid
Provider Details
| Authorized Official | VAID, PERMINDER (MANAGER) |
| NPI Enumeration Date | 08/22/2018 |
Related Entities
Other providers sharing the same authorized official: VAID, PERMINDER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
159 |
$228.61 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
56 |
40 |
$79.13 |
| D0220 |
Intraoral - periapical first radiographic image |
61 |
59 |
$75.38 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
28 |
$74.10 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$0.00 |