EXCELTH, INCORPORATED
NPI: 1164792404
· NEW ORLEANS, LA 70114
· Dentist
· NPI assigned 01/04/2012
$336K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: TENNESSEE, MATILDA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
297 |
$24K |
| 2019 |
996 |
$82K |
| 2020 |
285 |
$30K |
| 2021 |
797 |
$68K |
| 2022 |
724 |
$80K |
| 2023 |
499 |
$49K |
| 2024 |
74 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
3,467 |
2,334 |
$336K |
| D0274 |
Bitewings - four radiographic images |
81 |
68 |
$55.76 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
12 |
$22.34 |
| D1120 |
Prophylaxis - child |
15 |
13 |
$0.00 |
| D0330 |
Panoramic radiographic image |
13 |
12 |
$0.00 |
| D1110 |
Prophylaxis - adult |
13 |
12 |
$0.00 |
| D1330 |
|
43 |
39 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
15 |
13 |
$0.00 |