NADA TRABOULSI DDS, INC.
NPI: 1316309990
· BREA, CA 92821
· Dentist
· NPI assigned 03/23/2016
$727.00
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
13 |
$15.00 |
| 2021 |
29 |
$712.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$585.00 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$127.00 |
| D1999 |
|
13 |
13 |
$15.00 |