SU, CHARLES
NPI: 1184723801
· SACRAMENTO, CA 95823
· General Practice Dentistry
· NPI assigned 09/21/2006
$117K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,379 |
$15K |
| 2019 |
1,538 |
$23K |
| 2020 |
861 |
$10K |
| 2021 |
1,683 |
$25K |
| 2022 |
1,906 |
$30K |
| 2023 |
160 |
$2K |
| 2024 |
1,200 |
$12K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9430 |
|
1,080 |
1,027 |
$34K |
| D0220 |
Intraoral - periapical first radiographic image |
1,860 |
1,629 |
$22K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,125 |
1,296 |
$21K |
| D7140 |
Extraction, erupted tooth or exposed root |
244 |
96 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
216 |
208 |
$13K |
| D1110 |
Prophylaxis - adult |
72 |
69 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
104 |
99 |
$5K |
| D5850 |
|
26 |
24 |
$2K |