KIM ANH THI NGUYEN, DMD, INC.
NPI: 1174997936
· SAN DIEGO, CA 92128
· General Practice Dentistry
· NPI assigned 11/17/2015
$113K
Total Medicaid Paid
Provider Details
| Authorized Official | NGUYEN, KIM ANH (PRESIDENT) |
| NPI Enumeration Date | 11/17/2015 |
Related Entities
Other providers sharing the same authorized official: NGUYEN, KIM ANH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,208 |
$23K |
| 2019 |
1,005 |
$19K |
| 2020 |
803 |
$20K |
| 2021 |
584 |
$14K |
| 2022 |
651 |
$19K |
| 2023 |
312 |
$10K |
| 2024 |
708 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
965 |
960 |
$50K |
| D1206 |
Topical application of fluoride varnish |
1,449 |
1,438 |
$19K |
| D1120 |
Prophylaxis - child |
473 |
472 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
146 |
146 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,380 |
563 |
$5K |
| D1110 |
Prophylaxis - adult |
67 |
67 |
$5K |
| D0274 |
Bitewings - four radiographic images |
238 |
238 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
95 |
95 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
12 |
$1K |
| D0350 |
|
89 |
39 |
$662.40 |
| D0220 |
Intraoral - periapical first radiographic image |
36 |
36 |
$384.00 |
| D0240 |
|
26 |
13 |
$260.00 |
| D0602 |
|
68 |
68 |
$15.00 |
| D0603 |
|
13 |
13 |
$15.00 |
| D1330 |
|
169 |
168 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
18 |
18 |
$0.00 |
| D1999 |
|
20 |
20 |
$0.00 |