SEPIDEH TOLOUE
NPI: 1104099803
· SUNNYSIDE, NY 11104
· Dentist
· NPI assigned 04/02/2008
$121K
Total Medicaid Paid
Provider Details
| Authorized Official | TOLOUE, SEPIDEH (DENTIST) |
| NPI Enumeration Date | 04/02/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
72 |
$1K |
| 2019 |
105 |
$2K |
| 2020 |
707 |
$12K |
| 2021 |
1,565 |
$27K |
| 2022 |
1,441 |
$26K |
| 2023 |
1,675 |
$30K |
| 2024 |
1,181 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,509 |
1,508 |
$51K |
| D0120 |
Periodic oral evaluation - established patient |
1,616 |
1,615 |
$32K |
| D0274 |
Bitewings - four radiographic images |
1,109 |
1,109 |
$21K |
| D0220 |
Intraoral - periapical first radiographic image |
1,302 |
1,296 |
$12K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,192 |
1,190 |
$5K |
| D1999 |
|
18 |
15 |
$0.00 |