ST JUDES DENTAL CLINIC
NPI: 1356855332
· WASHINGTON, DC 20018
· General Practice Dentistry
· NPI assigned 11/28/2017
Provider Details
| Authorized Official | TAEME, BRUK (DR.) |
| NPI Enumeration Date | 11/28/2017 |
Related Entities
Other providers sharing the same authorized official: TAEME, BRUK
| Provider | City | State | Total Paid |
|---|
| YOHANNA |
WASHINGTON |
DC |
$7K |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
52 |
$2K |
| 2023 |
128 |
$5K |
| 2024 |
193 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
138 |
133 |
$8K |
| D1208 |
Topical application of fluoride, excluding varnish |
176 |
169 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$879.58 |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$820.42 |
| D0274 |
Bitewings - four radiographic images |
18 |
16 |
$515.25 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$338.68 |