SEAN BP SUNYOTO DDS INC
NPI: 1457996035
· BUENA PARK, CA 90621
· Dental Clinic/Center
· NPI assigned 11/07/2019
$121K
Total Medicaid Paid
Provider Details
| Authorized Official | SUNYOTO, SEAN (PRESIDENT) |
| NPI Enumeration Date | 11/07/2019 |
Related Entities
Other providers sharing the same authorized official: SUNYOTO, SEAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
29 |
$2K |
| 2021 |
634 |
$23K |
| 2022 |
656 |
$31K |
| 2023 |
570 |
$23K |
| 2024 |
940 |
$43K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
660 |
659 |
$43K |
| D1110 |
Prophylaxis - adult |
240 |
240 |
$21K |
| D0210 |
Intraoral - complete series of radiographic images |
388 |
388 |
$18K |
| D9430 |
|
320 |
291 |
$10K |
| D1208 |
Topical application of fluoride, excluding varnish |
486 |
486 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
84 |
84 |
$6K |
| D1120 |
Prophylaxis - child |
124 |
124 |
$5K |
| D0350 |
|
99 |
97 |
$3K |
| D0330 |
Panoramic radiographic image |
178 |
177 |
$3K |
| D1206 |
Topical application of fluoride varnish |
110 |
110 |
$1K |
| D4910 |
|
13 |
13 |
$1K |
| D1320 |
|
44 |
44 |
$762.50 |
| D0274 |
Bitewings - four radiographic images |
26 |
26 |
$507.60 |
| D0230 |
Intraoral - periapical each additional radiographic image |
57 |
29 |
$346.28 |