SORAYA ACEVEDO DDS, INC.
NPI: 1013484237
· MONTEBELLO, CA 90640
· General Practice Dentistry
· NPI assigned 10/25/2018
$181K
Total Medicaid Paid
Provider Details
| Authorized Official | ACEVEDO, LIDYA (DENTIST) |
| NPI Enumeration Date | 10/25/2018 |
Related Entities
Other providers sharing the same authorized official: ACEVEDO, LIDYA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
134 |
$7K |
| 2020 |
609 |
$30K |
| 2021 |
560 |
$30K |
| 2022 |
661 |
$32K |
| 2023 |
691 |
$35K |
| 2024 |
946 |
$46K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,370 |
1,358 |
$90K |
| D0210 |
Intraoral - complete series of radiographic images |
1,264 |
1,253 |
$59K |
| D1110 |
Prophylaxis - adult |
114 |
114 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
96 |
40 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
66 |
66 |
$5K |
| D1120 |
Prophylaxis - child |
55 |
54 |
$3K |
| D0350 |
|
265 |
262 |
$2K |
| D0274 |
Bitewings - four radiographic images |
117 |
117 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
28 |
13 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
226 |
118 |
$923.48 |