LISA VALDERUEDA, DMD, INC.
NPI: 1528548716
· WAIPAHU, HI 96797
· Dental Clinic/Center
· NPI assigned 08/16/2018
$135K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
886 |
$20K |
| 2020 |
922 |
$20K |
| 2021 |
1,065 |
$24K |
| 2022 |
814 |
$18K |
| 2023 |
1,035 |
$29K |
| 2024 |
740 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,767 |
1,767 |
$50K |
| D1110 |
Prophylaxis - adult |
677 |
677 |
$25K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,391 |
1,391 |
$21K |
| D0272 |
Bitewings - two radiographic images |
962 |
962 |
$18K |
| D1120 |
Prophylaxis - child |
585 |
585 |
$15K |
| D0210 |
Intraoral - complete series of radiographic images |
80 |
80 |
$5K |