5TH AVENUE DENTAL ASSOC LLP
NPI: 1184742298
· BROOKLYN, NY 11209
· Customized Equipment (DME)
· NPI assigned 03/27/2007
$744.00
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
28 |
$744.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$384.00 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$360.00 |