LIBRADA CALAYAG, DMD, INC
NPI: 1407238058
· VACAVILLE, CA 95687
· Health Maintenance Organization
· NPI assigned 06/19/2015
$171K
Total Medicaid Paid
Provider Details
| Authorized Official | CALAYAG, LIBRADA (DENTIST / OWNER) |
| Parent Organization | LIBRADA CALAYAG, DMD, INC |
| NPI Enumeration Date | 06/19/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,371 |
$23K |
| 2019 |
1,284 |
$31K |
| 2020 |
544 |
$9K |
| 2021 |
1,363 |
$31K |
| 2022 |
1,304 |
$33K |
| 2023 |
1,145 |
$26K |
| 2024 |
846 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,316 |
1,313 |
$83K |
| D1110 |
Prophylaxis - adult |
454 |
449 |
$39K |
| D0274 |
Bitewings - four radiographic images |
1,346 |
1,341 |
$29K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,701 |
1,714 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
27 |
27 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$156.00 |