LOURDES R. GAERLAN, D.M.D., INC.
NPI: 1104027895
· SUISUN CITY, CA 94585
· Dentist
· NPI assigned 05/30/2007
$112K
Total Medicaid Paid
3,548
Beneficiary Records
Provider Details
| Authorized Official | GAERLAN, LOURDES (OFFICE MANAGER) |
| NPI Enumeration Date | 05/30/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,131 |
$27K |
| 2019 |
1,578 |
$42K |
| 2020 |
188 |
$6K |
| 2021 |
561 |
$16K |
| 2022 |
309 |
$15K |
| 2023 |
134 |
$7K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,242 |
1,242 |
$58K |
| D1120 |
Prophylaxis - child |
877 |
877 |
$27K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
117 |
77 |
$7K |
| D0274 |
Bitewings - four radiographic images |
312 |
312 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
641 |
640 |
$6K |
| D0350 |
|
471 |
267 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
43 |
27 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
198 |
106 |
$793.80 |