BLU DENTAL GROUP PC
NPI: 1326559022
· TYLER, TX 75701
· General Practice Dentistry
· NPI assigned 10/20/2017
Provider Details
| Authorized Official | KIM, TORI (MANAGER) |
| NPI Enumeration Date | 10/20/2017 |
Related Entities
Other providers sharing the same authorized official: KIM, TORI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
588 |
$10K |
| 2022 |
572 |
$10K |
| 2023 |
294 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
167 |
150 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
306 |
270 |
$7K |
| D0274 |
Bitewings - four radiographic images |
159 |
145 |
$4K |
| D1120 |
Prophylaxis - child |
94 |
83 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
197 |
178 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
32 |
13 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
15 |
15 |
$988.96 |
| D0272 |
Bitewings - two radiographic images |
32 |
30 |
$607.88 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$494.48 |
| D0601 |
|
204 |
198 |
$0.00 |
| D0603 |
|
234 |
203 |
$0.00 |