ELIZABETH SOTOMIL DDS, INC
NPI: 1184185753
· MODESTO, CA 95355
· Dental Clinic/Center
· NPI assigned 03/27/2019
$279K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
148 |
$8K |
| 2021 |
106 |
$6K |
| 2022 |
628 |
$51K |
| 2023 |
1,140 |
$158K |
| 2024 |
402 |
$56K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
323 |
277 |
$148K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
983 |
973 |
$64K |
| D0210 |
Intraoral - complete series of radiographic images |
841 |
832 |
$40K |
| D3320 |
|
41 |
33 |
$15K |
| D3310 |
|
20 |
13 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
54 |
25 |
$3K |
| D1206 |
Topical application of fluoride varnish |
101 |
101 |
$2K |
| D9430 |
|
12 |
12 |
$384.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
49 |
28 |
$202.50 |