RESERVOIR DENTAL LLC
NPI: 1609553759
· CRANSTON, RI 02910
· General Practice Dentistry
· NPI assigned 06/30/2023
$553K
Total Medicaid Paid
Provider Details
| Authorized Official | BOTEZATU, VLAD (DENTIST) |
| NPI Enumeration Date | 06/30/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
1,173 |
$102K |
| 2024 |
4,996 |
$451K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,031 |
1,082 |
$294K |
| D0330 |
Panoramic radiographic image |
1,518 |
1,444 |
$96K |
| D7140 |
Extraction, erupted tooth or exposed root |
858 |
262 |
$63K |
| D0140 |
Limited oral evaluation - problem focused |
1,487 |
1,408 |
$59K |
| D7230 |
|
104 |
85 |
$26K |
| D7220 |
|
33 |
26 |
$6K |
| D9110 |
|
123 |
122 |
$5K |
| D7240 |
Removal of impacted tooth - completely bony |
15 |
12 |
$4K |