PHOENIX PEDIATRIC DENTAL
NPI: 1437547775
· PHOENIX, AZ 85015
· Pediatric Dentist
· NPI assigned 01/08/2015
Provider Details
| Authorized Official | PACHECO, LUZ (HUMAN RESOURCE) |
| NPI Enumeration Date | 01/08/2015 |
Related Entities
Other providers sharing the same authorized official: PACHECO, LUZ
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
646 |
$8K |
| 2022 |
2,354 |
$36K |
| 2023 |
953 |
$15K |
| 2024 |
213 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
440 |
411 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
441 |
413 |
$10K |
| D1208 |
Topical application of fluoride, excluding varnish |
550 |
519 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,045 |
519 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
578 |
536 |
$7K |
| D0272 |
Bitewings - two radiographic images |
324 |
297 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
38 |
13 |
$3K |
| D1110 |
Prophylaxis - adult |
30 |
28 |
$1K |
| D0274 |
Bitewings - four radiographic images |
25 |
25 |
$718.42 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$505.32 |
| D0330 |
Panoramic radiographic image |
15 |
14 |
$226.82 |
| D1330 |
|
98 |
98 |
$0.00 |
| D1999 |
|
569 |
517 |
$0.00 |