KINGS 26 DENTISTRY
NPI: 1376793414
· OZONE PARK, NY 11417
· General Practice Dentistry
· NPI assigned 09/25/2008
$126K
Total Medicaid Paid
Provider Details
| Authorized Official | KHALILI, FARAMARZ (PRIMARY PROVIDER) |
| NPI Enumeration Date | 09/25/2008 |
Related Entities
Other providers sharing the same authorized official: KHALILI, FARAMARZ
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,976 |
$31K |
| 2019 |
2,144 |
$34K |
| 2020 |
2,270 |
$39K |
| 2021 |
1,335 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,152 |
1,152 |
$37K |
| D0120 |
Periodic oral evaluation - established patient |
1,346 |
1,345 |
$26K |
| D0274 |
Bitewings - four radiographic images |
823 |
823 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
1,473 |
1,473 |
$13K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,522 |
1,522 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
509 |
509 |
$7K |
| D1120 |
Prophylaxis - child |
222 |
222 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
442 |
442 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
192 |
192 |
$4K |
| D0272 |
Bitewings - two radiographic images |
27 |
27 |
$291.20 |
| D0330 |
Panoramic radiographic image |
17 |
17 |
$264.16 |