SANTA MARIA DENTAL OFFICE INC
NPI: 1275608010
· HAWTHORNE, CA 90250
· General Practice Dentistry
· NPI assigned 11/21/2006
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | ROFAEL, NAWAL (PRESIDENT) |
| NPI Enumeration Date | 11/21/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
465 |
$0.00 |
| 2019 |
118 |
$0.00 |
| 2020 |
127 |
$0.00 |
| 2021 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
65 |
64 |
$0.00 |
| D1120 |
Prophylaxis - child |
167 |
164 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
170 |
163 |
$0.00 |
| D1330 |
|
80 |
78 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
15 |
15 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
128 |
125 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
24 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
60 |
59 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
14 |
13 |
$0.00 |