ELBASTY, MOHAMED
NPI: 1205819083
· HOLMDEL, NJ 07733
· Dentist
· NPI assigned 11/25/2005
$234.25
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
72 |
$234.25 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$108.00 |
| D0220 |
Intraoral - periapical first radiographic image |
28 |
28 |
$54.25 |
| D0274 |
Bitewings - four radiographic images |
14 |
14 |
$54.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
16 |
16 |
$18.00 |