ELICA HEALTH CENTERS
NPI: 1265059182
· SACRAMENTO, CA 95825
· Case Manager/Care Coordinator
· NPI assigned 06/26/2020
Provider Details
| Authorized Official | BAK, TATYANA (CEO) |
| Parent Organization | ELICA HEALTH CENTERS |
| NPI Enumeration Date | 06/26/2020 |
Related Entities
Other providers sharing the same authorized official: BAK, TATYANA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
349 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1310 |
|
52 |
51 |
$923.89 |
| D1120 |
Prophylaxis - child |
45 |
44 |
$880.71 |
| D1206 |
Topical application of fluoride varnish |
52 |
51 |
$368.94 |
| D0603 |
|
40 |
40 |
$271.17 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$0.00 |
| D0350 |
|
12 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
36 |
36 |
$0.00 |
| D0240 |
|
20 |
12 |
$0.00 |
| D1330 |
|
64 |
63 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$0.00 |