TRACY NGO DDS INC
NPI: 1225198005
· SANTA CLARA, CA 95050
· General Practice Dentistry
· NPI assigned 12/11/2006
$161K
Total Medicaid Paid
Provider Details
| Authorized Official | NGO, TRACY (PRESIDENT) |
| NPI Enumeration Date | 12/11/2006 |
Related Entities
Other providers sharing the same authorized official: NGO, TRACY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,017 |
$17K |
| 2019 |
809 |
$17K |
| 2020 |
745 |
$14K |
| 2021 |
945 |
$18K |
| 2022 |
991 |
$31K |
| 2023 |
841 |
$31K |
| 2024 |
1,056 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,330 |
1,325 |
$74K |
| D1120 |
Prophylaxis - child |
1,447 |
1,441 |
$57K |
| D1206 |
Topical application of fluoride varnish |
1,352 |
1,349 |
$16K |
| D0272 |
Bitewings - two radiographic images |
536 |
536 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,541 |
644 |
$6K |
| D1320 |
|
160 |
159 |
$1K |
| D1330 |
|
38 |
38 |
$0.00 |