K DENTAL LLC
NPI: 1154982775
· PHILADELPHIA, PA 19149
· Dental Clinic/Center
· NPI assigned 06/25/2019
$621.60
Total Medicaid Paid
Provider Details
| Authorized Official | MORINA, ALKETA (OWNER) |
| NPI Enumeration Date | 06/25/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
38 |
$621.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$280.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$253.60 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$88.00 |