MEDBAR DENTAL SERVICE PSC
NPI: 1245419068
· CAYEY, PR 00736
· Dentist
· NPI assigned 10/29/2007
$121K
Total Medicaid Paid
Provider Details
| Authorized Official | MEDINA, THOMAS (PRESIDENT) |
| NPI Enumeration Date | 10/29/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
72 |
$1K |
| 2020 |
158 |
$4K |
| 2021 |
354 |
$7K |
| 2022 |
1,317 |
$27K |
| 2023 |
1,856 |
$32K |
| 2024 |
2,743 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1999 |
|
1,632 |
1,159 |
$24K |
| D1110 |
Prophylaxis - adult |
776 |
571 |
$24K |
| D1120 |
Prophylaxis - child |
903 |
678 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,065 |
792 |
$16K |
| D0272 |
Bitewings - two radiographic images |
694 |
494 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
454 |
328 |
$10K |
| D0330 |
Panoramic radiographic image |
323 |
244 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
585 |
406 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
68 |
65 |
$472.33 |