DAFONSECA, MARCIO
NPI: 1548353295
· COLUMBUS, OH 43205
· Pediatric Dentist
· NPI assigned 10/02/2006
$124K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
99 |
$35K |
| 2024 |
305 |
$89K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
Prefabricated stainless steel crown - primary tooth |
135 |
63 |
$79K |
| D7140 |
Extraction, erupted tooth or exposed root |
169 |
61 |
$42K |
| D0120 |
Periodic oral evaluation - established patient |
46 |
46 |
$2K |
| D1120 |
Prophylaxis - child |
27 |
27 |
$931.86 |
| D1206 |
Topical application of fluoride varnish |
27 |
27 |
$701.67 |