SPRINGVALLEYDENTALCAREPC
NPI: 1255619458
· SPRING VALLEY, NY 10977
· General Practice Dentistry
· NPI assigned 07/22/2011
$447K
Total Medicaid Paid
Provider Details
| Authorized Official | DULUC, CARLOS (OWNER) |
| NPI Enumeration Date | 07/22/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,461 |
$77K |
| 2019 |
4,163 |
$83K |
| 2020 |
3,802 |
$73K |
| 2021 |
3,425 |
$67K |
| 2022 |
4,141 |
$82K |
| 2023 |
3,054 |
$65K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,673 |
2,673 |
$110K |
| D0120 |
Periodic oral evaluation - established patient |
4,579 |
4,578 |
$98K |
| D0274 |
Bitewings - four radiographic images |
3,461 |
3,460 |
$74K |
| D1120 |
Prophylaxis - child |
1,404 |
1,404 |
$45K |
| D0220 |
Intraoral - periapical first radiographic image |
4,231 |
4,221 |
$44K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,990 |
3,980 |
$40K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
203 |
192 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,364 |
1,364 |
$16K |
| D2140 |
|
54 |
47 |
$4K |
| D1999 |
|
87 |
87 |
$0.00 |