C MARCELLO DDS, MSD, LLC
NPI: 1528704756
· THIBODAUX, LA 70301
· Pediatric Dentist
· NPI assigned 05/10/2022
$113K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
936 |
$21K |
| 2023 |
1,726 |
$48K |
| 2024 |
1,262 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,053 |
1,024 |
$42K |
| D1206 |
Topical application of fluoride varnish |
757 |
749 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
666 |
643 |
$20K |
| D0145 |
Oral evaluation for a patient under three years of age |
220 |
220 |
$13K |
| D0220 |
Intraoral - periapical first radiographic image |
353 |
337 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
475 |
284 |
$4K |
| D0272 |
Bitewings - two radiographic images |
189 |
179 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
140 |
140 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
71 |
62 |
$1K |