ESOPUS DENTAL, PC
NPI: 1508885898
· RIFTON, NY 12471
· General Practice Dentistry
· NPI assigned 07/18/2006
$260K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
245 |
$10K |
| 2020 |
1,812 |
$63K |
| 2021 |
1,929 |
$65K |
| 2022 |
2,326 |
$80K |
| 2023 |
1,244 |
$43K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,958 |
1,958 |
$102K |
| D0120 |
Periodic oral evaluation - established patient |
2,222 |
2,222 |
$60K |
| D0274 |
Bitewings - four radiographic images |
1,865 |
1,863 |
$51K |
| D1120 |
Prophylaxis - child |
644 |
644 |
$23K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
418 |
417 |
$12K |
| D1206 |
Topical application of fluoride varnish |
375 |
374 |
$11K |
| D0272 |
Bitewings - two radiographic images |
62 |
62 |
$990.76 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$168.00 |