AGUNG PRIBADI DDS INC
NPI: 1295830487
· LA HABRA, CA 90631
· General Practice Dentistry
· NPI assigned 09/13/2006
Provider Details
| Authorized Official | PRIBADI, AGUNG (CEO) |
| NPI Enumeration Date | 09/13/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
274 |
$5K |
| 2019 |
294 |
$7K |
| 2020 |
319 |
$7K |
| 2021 |
467 |
$9K |
| 2022 |
380 |
$12K |
| 2023 |
572 |
$19K |
| 2024 |
277 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
558 |
558 |
$34K |
| D0230 |
Intraoral - periapical each additional radiographic image |
838 |
811 |
$11K |
| D1120 |
Prophylaxis - child |
265 |
265 |
$10K |
| D1208 |
Topical application of fluoride, excluding varnish |
769 |
769 |
$10K |
| D0274 |
Bitewings - four radiographic images |
141 |
141 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$761.00 |