FAMILY DENTISTRY OF ELMHURST
NPI: 1407121692
· ELMHURST, NY 11373
· General Practice Dentistry
· NPI assigned 03/20/2012
$160K
Total Medicaid Paid
Provider Details
| Authorized Official | FILION, LUZ (OWNER) |
| NPI Enumeration Date | 03/20/2012 |
Related Entities
Other providers sharing the same authorized official: FILION, LUZ
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
231 |
$6K |
| 2019 |
292 |
$6K |
| 2020 |
335 |
$10K |
| 2021 |
889 |
$27K |
| 2022 |
791 |
$18K |
| 2023 |
2,080 |
$51K |
| 2024 |
1,706 |
$42K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,574 |
1,571 |
$66K |
| D0120 |
Periodic oral evaluation - established patient |
1,053 |
1,051 |
$23K |
| D0274 |
Bitewings - four radiographic images |
809 |
809 |
$18K |
| D0210 |
Intraoral - complete series of radiographic images |
401 |
400 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
1,051 |
1,048 |
$10K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
135 |
85 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
345 |
345 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
916 |
916 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
40 |
25 |
$3K |