ELBASTY PEDIATRIC AN DENTA ASSOC.
NPI: 1487883559
· HOLMDEL, NJ 07733
· Dentist
· NPI assigned 07/09/2009
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
93 |
$506.00 |
| 2020 |
90 |
$281.50 |
| 2021 |
73 |
$488.50 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
74 |
74 |
$782.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$253.00 |
| D0274 |
Bitewings - four radiographic images |
39 |
39 |
$126.00 |
| D0220 |
Intraoral - periapical first radiographic image |
59 |
59 |
$60.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
58 |
58 |
$55.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$0.00 |