NPI: 1427795327 · WEST COVINA, CA 91792 · Dental Clinic/Center · NPI assigned 05/13/2022
| Authorized Official | MOTAMEDI, AMIR (OWNER) |
| NPI Enumeration Date | 05/13/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 290 | $11K |
| 2024 | 248 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 263 | 263 | $17K |
| D0210 | Intraoral - complete series of radiographic images | 103 | 103 | $5K |
| D1110 | Prophylaxis - adult | 12 | 12 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 110 | 28 | $481.95 |
| D1208 | Topical application of fluoride, excluding varnish | 26 | 26 | $386.00 |
| D9430 | 12 | 12 | $384.00 | |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $132.10 |