GONCALVES, ANTONIO
NPI: 1467506881
· PROVIDENCE, RI 02903
· General Practice Dentistry
· NPI assigned 01/23/2007
$107K
Total Medicaid Paid
2,999
Beneficiary Records
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
426 |
$15K |
| 2019 |
495 |
$18K |
| 2020 |
318 |
$9K |
| 2021 |
472 |
$15K |
| 2022 |
536 |
$19K |
| 2023 |
473 |
$17K |
| 2024 |
375 |
$14K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,420 |
1,376 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
1,510 |
1,465 |
$33K |
| D0272 |
Bitewings - two radiographic images |
124 |
117 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$290.00 |
| D1999 |
|
29 |
29 |
$0.00 |