ASHWAQ DENTAL ONE, LLC
NPI: 1144757196
· ANTHEM, AZ 85086
· Dental Clinic/Center
· NPI assigned 05/20/2017
$61.38
Total Medicaid Paid
Provider Details
| Authorized Official | KAYAT, ISAIMA (MANAGER) |
| NPI Enumeration Date | 05/20/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
42 |
$61.38 |
| 2024 |
38 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
30 |
28 |
$48.38 |
| D1208 |
Topical application of fluoride, excluding varnish |
26 |
26 |
$13.00 |
| D0274 |
Bitewings - four radiographic images |
24 |
24 |
$0.00 |