CLOVER DENTAL CARE LLC
NPI: 1194431056
· WALLINGFORD, CT 06492
· General Practice Dentistry
· NPI assigned 01/24/2023
Provider Details
| Authorized Official | KU, RYAN (MEMBER) |
| NPI Enumeration Date | 01/24/2023 |
Related Entities
Other providers sharing the same authorized official: KU, RYAN
| Provider | City | State | Total Paid |
|---|
| BON DENTAL |
WEST HAVEN |
CT |
$186K |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
185 |
$4K |
| 2024 |
1,771 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
150 |
70 |
$10K |
| D1110 |
Prophylaxis - adult |
237 |
221 |
$8K |
| D0274 |
Bitewings - four radiographic images |
226 |
216 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
228 |
212 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
400 |
348 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
209 |
202 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
377 |
234 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
89 |
81 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
40 |
40 |
$2K |