MIN LWIN DDS
NPI: 1356731699
· SAN GABRIEL, CA 91776
· General Practice Dentistry
· NPI assigned 01/26/2015
$39.35
Total Medicaid Paid
Provider Details
| Authorized Official | LWIN, MIN (OWNER) |
| NPI Enumeration Date | 01/26/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
172 |
$0.00 |
| 2022 |
279 |
$0.00 |
| 2023 |
155 |
$39.35 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
161 |
161 |
$30.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
116 |
81 |
$5.25 |
| D0220 |
Intraoral - periapical first radiographic image |
164 |
111 |
$2.10 |
| D0272 |
Bitewings - two radiographic images |
115 |
115 |
$2.00 |
| D1206 |
Topical application of fluoride varnish |
25 |
25 |
$0.00 |
| D1120 |
Prophylaxis - child |
25 |
25 |
$0.00 |