MA. THERESA M. RAMOS DMD INC
NPI: 1609018100
· UPLAND, CA 91784
· General Practice Dentistry
· NPI assigned 03/30/2009
$169K
Total Medicaid Paid
Provider Details
| Authorized Official | RAMOS, THERESA (CEO) |
| NPI Enumeration Date | 03/30/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,178 |
$19K |
| 2019 |
1,387 |
$26K |
| 2020 |
873 |
$14K |
| 2021 |
572 |
$14K |
| 2022 |
1,093 |
$34K |
| 2023 |
1,181 |
$33K |
| 2024 |
1,052 |
$30K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,095 |
1,088 |
$59K |
| D1110 |
Prophylaxis - adult |
389 |
383 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,675 |
1,669 |
$23K |
| D1120 |
Prophylaxis - child |
582 |
581 |
$21K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,079 |
644 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
119 |
119 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
125 |
125 |
$6K |
| D0274 |
Bitewings - four radiographic images |
119 |
119 |
$3K |
| D4910 |
|
15 |
15 |
$1K |
| D0350 |
|
89 |
40 |
$806.40 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$144.00 |
| D1999 |
|
37 |
37 |
$0.00 |