TESSIE T SY DDS. A PROFESSIONAL CORPORATION
NPI: 1447470042
· EL MONTE, CA 91732
· General Practice Dentistry
· NPI assigned 04/26/2007
$153K
Total Medicaid Paid
Provider Details
| Authorized Official | SY, TESSIE (PRESIDENT) |
| NPI Enumeration Date | 04/26/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,302 |
$13K |
| 2019 |
1,160 |
$12K |
| 2020 |
1,193 |
$13K |
| 2021 |
1,761 |
$17K |
| 2022 |
2,120 |
$32K |
| 2023 |
2,529 |
$36K |
| 2024 |
2,187 |
$31K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
785 |
781 |
$50K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,506 |
1,635 |
$38K |
| D0274 |
Bitewings - four radiographic images |
1,013 |
1,008 |
$22K |
| D1120 |
Prophylaxis - child |
527 |
525 |
$21K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,113 |
1,108 |
$15K |
| D4910 |
|
55 |
55 |
$4K |
| D0350 |
|
144 |
65 |
$2K |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$990.00 |
| D0272 |
Bitewings - two radiographic images |
13 |
13 |
$156.00 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
12 |
$150.00 |
| D1330 |
|
13 |
13 |
$0.00 |
| D1999 |
|
39 |
36 |
$0.00 |