SOLTERRA DENTISTRY LLC
NPI: 1003421009
· PHOENIX, AZ 85032
· Dental Clinic/Center
· NPI assigned 09/15/2020
$318.70
Total Medicaid Paid
Provider Details
| Authorized Official | GOOLSBY, TERA (ACCOUNTANT) |
| NPI Enumeration Date | 09/15/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
87 |
$11.90 |
| 2022 |
90 |
$47.60 |
| 2023 |
165 |
$211.00 |
| 2024 |
72 |
$48.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
361 |
317 |
$203.50 |
| D0140 |
Limited oral evaluation - problem focused |
40 |
38 |
$95.64 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$19.56 |