PEDODONTIC ASSOCIATES, INC
NPI: 1285603373
· AIEA, HI 96701
· Pediatric Dentist
· NPI assigned 03/14/2006
$259K
Total Medicaid Paid
Provider Details
| Authorized Official | SATO, ALAN (D.D.S. / HIPPA PRIVACY-SECURITY OF.) |
| NPI Enumeration Date | 03/14/2006 |
Related Entities
Other providers sharing the same authorized official: SATO, ALAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,576 |
$73K |
| 2019 |
2,902 |
$65K |
| 2020 |
474 |
$11K |
| 2022 |
546 |
$9K |
| 2023 |
1,519 |
$27K |
| 2024 |
3,429 |
$74K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
3,403 |
3,403 |
$91K |
| D1120 |
Prophylaxis - child |
2,717 |
2,717 |
$76K |
| D1206 |
Topical application of fluoride varnish |
2,840 |
2,840 |
$49K |
| D0272 |
Bitewings - two radiographic images |
862 |
862 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
851 |
849 |
$10K |
| D0274 |
Bitewings - four radiographic images |
209 |
209 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
591 |
586 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
876 |
876 |
$4K |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$1K |
| D1354 |
|
57 |
17 |
$615.60 |