PRIBADI, DARMAWAN
NPI: 1508908534
· POMONA, CA 91766
· Dentist
· NPI assigned 02/13/2007
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
569 |
$10K |
| 2019 |
754 |
$16K |
| 2020 |
433 |
$10K |
| 2021 |
410 |
$8K |
| 2022 |
351 |
$11K |
| 2023 |
119 |
$2K |
| 2024 |
183 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
412 |
410 |
$20K |
| D1110 |
Prophylaxis - adult |
155 |
155 |
$12K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,158 |
1,134 |
$11K |
| D0272 |
Bitewings - two radiographic images |
733 |
730 |
$9K |
| D1120 |
Prophylaxis - child |
199 |
199 |
$6K |
| D1351 |
Sealant - per tooth |
74 |
14 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$924.00 |
| D0220 |
Intraoral - periapical first radiographic image |
74 |
69 |
$854.00 |