DR. RUSEN VICTORVILLE FRIENDLY SMILES DENTAL INC.
NPI: 1518639681
· VICTORVILLE, CA 92392
· Dentist
· NPI assigned 09/28/2021
$156K
Total Medicaid Paid
Provider Details
| Authorized Official | RUSEN, RARES (CEO) |
| NPI Enumeration Date | 09/28/2021 |
Related Entities
Other providers sharing the same authorized official: RUSEN, RARES
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,468 |
$23K |
| 2022 |
3,402 |
$36K |
| 2023 |
4,835 |
$56K |
| 2024 |
3,768 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0350 |
|
4,515 |
1,115 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
499 |
495 |
$33K |
| D0230 |
Intraoral - periapical each additional radiographic image |
6,138 |
1,154 |
$26K |
| D0274 |
Bitewings - four radiographic images |
548 |
546 |
$12K |
| D9110 |
|
174 |
89 |
$10K |
| D1120 |
Prophylaxis - child |
176 |
176 |
$8K |
| D9430 |
|
245 |
221 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
438 |
436 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
552 |
479 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
67 |
67 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
34 |
25 |
$2K |
| D1351 |
Sealant - per tooth |
61 |
13 |
$1K |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$967.50 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
14 |
$576.00 |