EAST VICTORY DRIVE DENTAL GROUP, LLC
NPI: 1497205637
· SAVANNAH, GA 31404
· General Practice Dentistry
· NPI assigned 10/12/2016
Provider Details
| Authorized Official | ELKIN, PAUL (PRESIDENT AND OWNER) |
| NPI Enumeration Date | 10/12/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
447 |
$9K |
| 2019 |
267 |
$6K |
| 2020 |
230 |
$5K |
| 2021 |
153 |
$4K |
| 2022 |
147 |
$3K |
| 2023 |
172 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
495 |
495 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
292 |
292 |
$5K |
| D1206 |
Topical application of fluoride varnish |
281 |
281 |
$5K |
| D1120 |
Prophylaxis - child |
107 |
107 |
$4K |
| D1110 |
Prophylaxis - adult |
41 |
41 |
$2K |
| D0274 |
Bitewings - four radiographic images |
54 |
54 |
$1K |
| D0272 |
Bitewings - two radiographic images |
51 |
51 |
$951.85 |
| D0230 |
Intraoral - periapical each additional radiographic image |
52 |
52 |
$564.07 |
| D0220 |
Intraoral - periapical first radiographic image |
43 |
42 |
$556.45 |