AMY BERHANU DEMISSIE DDS PC
NPI: 1215009246
· BANNING, CA 92220
· Dentist
· NPI assigned 11/14/2006
$394K
Total Medicaid Paid
Provider Details
| Authorized Official | DEMISSIE, AMSALE (PRESIDENT) |
| NPI Enumeration Date | 11/14/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,578 |
$43K |
| 2019 |
2,204 |
$43K |
| 2020 |
1,552 |
$35K |
| 2021 |
2,684 |
$65K |
| 2022 |
3,281 |
$94K |
| 2023 |
2,418 |
$62K |
| 2024 |
1,970 |
$52K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
|
1,971 |
1,968 |
$108K |
| D1120 |
|
1,666 |
1,664 |
$59K |
| D1110 |
|
538 |
537 |
$47K |
| D0150 |
|
606 |
606 |
$40K |
| D1208 |
|
2,889 |
2,885 |
$34K |
| D0230 |
|
5,950 |
1,995 |
$24K |
| D0210 |
|
419 |
419 |
$20K |
| D9430 |
|
603 |
594 |
$19K |
| D0220 |
|
1,312 |
1,277 |
$16K |
| D2391 |
|
214 |
111 |
$12K |
| D0274 |
|
410 |
408 |
$9K |
| D2392 |
|
51 |
37 |
$3K |
| D4341 |
|
46 |
13 |
$3K |
| D0272 |
|
12 |
12 |
$144.00 |