CLEVELAND DENTAL PLLC
NPI: 1124869342
· CLEVELAND, TX 77327
· Dentist
· NPI assigned 06/03/2024
Provider Details
| Authorized Official | ORTEGA, LUIS (OWNER) |
| NPI Enumeration Date | 06/03/2024 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
316 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
51 |
51 |
$1K |
| D1120 |
Prophylaxis - child |
30 |
30 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
53 |
53 |
$764.40 |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$658.56 |
| D0220 |
Intraoral - periapical first radiographic image |
44 |
44 |
$540.08 |
| D0230 |
Intraoral - periapical each additional radiographic image |
43 |
43 |
$483.42 |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$350.70 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$346.10 |
| D0602 |
|
28 |
28 |
$0.00 |
| D0603 |
|
14 |
14 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |