MATOS-PERROTTE, VIRGINIA
NPI: 1144202110
· NEW BRUNSWICK, NJ 08901
· Dentist
· NPI assigned 11/16/2005
$306.75
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
76 |
$306.75 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$104.00 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$91.00 |
| D0220 |
Intraoral - periapical first radiographic image |
34 |
34 |
$78.75 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
14 |
$33.00 |