SOUTH VIENNA FAMILY DENTAL
NPI: 1023416294
· SOUTH VIENNA, OH 45369
· General Practice Dentistry
· NPI assigned 12/19/2014
Provider Details
| Authorized Official | KHAN, IRFAN (OWNER) |
| NPI Enumeration Date | 12/19/2014 |
Related Entities
Other providers sharing the same authorized official: KHAN, IRFAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
41 |
$965.95 |
| 2019 |
101 |
$2K |
| 2020 |
253 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
84 |
82 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
62 |
52 |
$1K |
| D1110 |
Prophylaxis - adult |
17 |
14 |
$546.08 |
| D0330 |
Panoramic radiographic image |
14 |
13 |
$509.52 |
| D0220 |
Intraoral - periapical first radiographic image |
98 |
83 |
$417.00 |
| D0120 |
Periodic oral evaluation - established patient |
25 |
21 |
$406.92 |
| D0230 |
Intraoral - periapical each additional radiographic image |
77 |
70 |
$375.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
18 |
15 |
$270.00 |