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MONTOYA PEDIATRIC DENTISTRY LLC DBA SAN TAN PEDIATRIC DENTAL
MONTOYA PEDIATRIC DENTISTRY LLC DBA SAN TAN PEDIATRIC DENTAL
NPI: 1467607218
· QUEEN CREEK, AZ 85243
· 1223P0221X
$235K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
8,855 |
$82K |
| 2019 |
12,866 |
$118K |
| 2020 |
4,158 |
$35K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
2,794 |
2,640 |
$38K |
| D0120 |
|
3,235 |
3,089 |
$26K |
| D1206 |
|
3,502 |
3,306 |
$23K |
| D2392 |
|
674 |
278 |
$19K |
| D0274 |
|
1,589 |
1,521 |
$17K |
| D1110 |
|
920 |
886 |
$15K |
| D0272 |
|
1,963 |
1,856 |
$14K |
| D1351 |
|
1,256 |
287 |
$13K |
| D0220 |
|
2,704 |
2,534 |
$13K |
| D0150 |
|
651 |
615 |
$12K |
| D0230 |
|
2,794 |
2,343 |
$11K |
| D0240 |
|
1,607 |
1,236 |
$10K |
| D0330 |
|
747 |
685 |
$9K |
| D9230 |
|
657 |
592 |
$5K |
| D7140 |
|
89 |
39 |
$2K |
| D2930 |
|
36 |
15 |
$2K |
| D1208 |
|
297 |
292 |
$2K |
| D0140 |
|
141 |
130 |
$2K |
| D0145 |
|
125 |
112 |
$1K |
| D0210 |
|
75 |
71 |
$547.36 |
| D2391 |
|
23 |
16 |
$318.98 |