KHAFSAFARD, ALI
NPI: 1245321827
· LONDON, OH 43140
· Dentist
· NPI assigned 09/27/2006
$791.52
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
47 |
$791.52 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
21 |
19 |
$324.52 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$272.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$195.00 |