AVALON DENTAL LLC
NPI: 1497896682
· WILMINGTON, DE 19804
· General Practice Dentistry
· NPI assigned 02/09/2007
$108K
Total Medicaid Paid
Provider Details
| Authorized Official | FARHI, PARHAM (OWNER) |
| NPI Enumeration Date | 02/09/2007 |
Related Entities
Other providers sharing the same authorized official: FARHI, PARHAM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
195 |
$9K |
| 2022 |
918 |
$85K |
| 2023 |
157 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
133 |
83 |
$34K |
| D1110 |
Prophylaxis - adult |
415 |
390 |
$29K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
227 |
203 |
$15K |
| D0210 |
Intraoral - complete series of radiographic images |
149 |
149 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
201 |
201 |
$8K |
| D0274 |
Bitewings - four radiographic images |
76 |
73 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
13 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
39 |
39 |
$902.80 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
12 |
$269.62 |