RICUCCIO A. NEGOM DDS, A PROFESSIOAL DENTAL CORPORATION
NPI: 1134399892
· SAN LUIS OBISPO, CA 93401
· Dental Clinic/Center
· NPI assigned 03/09/2008
Provider Details
| Authorized Official | NEGOM, RICUCCIO (OWNER, DIRECTOR, OFFICER) |
| NPI Enumeration Date | 03/09/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
85 |
$2K |
| 2019 |
12 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
28 |
28 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
28 |
$945.00 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$216.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
29 |
14 |
$120.00 |