LIZA DENTAL MANAGEMENT INC.
NPI: 1356489116
· HILLSIDE, NJ 07205
· Dental Clinic/Center
· NPI assigned 02/02/2007
$276.25
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
13 |
$26.25 |
| 2021 |
17 |
$250.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
17 |
17 |
$250.00 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
12 |
$26.25 |