NPI: 1588981229 · SAN FERNANDO, CA 91340 · Exclusive Provider Organization · NPI assigned 04/20/2010
| Authorized Official | ILAGAN, MARIA (OWNER/DENTIST) |
| NPI Enumeration Date | 04/20/2010 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 458 | $6K |
| 2019 | 387 | $7K |
| 2020 | 247 | $3K |
| 2021 | 163 | $2K |
| 2022 | 66 | $2K |
| 2023 | 37 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 220 | 220 | $10K |
| D1120 | Prophylaxis - child | 203 | 203 | $6K |
| D1206 | Topical application of fluoride varnish | 373 | 373 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 54 | 50 | $821.50 |
| D0230 | Intraoral - periapical each additional radiographic image | 107 | 57 | $367.50 |
| D1999 | 33 | 33 | $0.00 | |
| D1330 | 368 | 368 | $0.00 |