SUMMIT DENTAL ASSOCIATES P.C
NPI: 1558491837
· YONKERS, NY 10703
· Pediatric Dentist
· NPI assigned 03/06/2007
$196K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,684 |
$45K |
| 2019 |
1,893 |
$43K |
| 2020 |
1,440 |
$32K |
| 2021 |
1,047 |
$23K |
| 2022 |
1,121 |
$25K |
| 2023 |
714 |
$16K |
| 2024 |
504 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,998 |
2,988 |
$64K |
| D1120 |
Prophylaxis - child |
1,736 |
1,730 |
$56K |
| D1110 |
Prophylaxis - adult |
932 |
929 |
$39K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,551 |
2,543 |
$32K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
30 |
28 |
$2K |
| D0274 |
Bitewings - four radiographic images |
77 |
76 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
15 |
13 |
$869.00 |
| D0272 |
Bitewings - two radiographic images |
64 |
64 |
$772.08 |