SUH, INAE
NPI: 1619034998
· ANAHEIM, CA 92804
· Dentist
· NPI assigned 01/03/2007
$105K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,365 |
$33K |
| 2019 |
1,119 |
$28K |
| 2020 |
207 |
$4K |
| 2021 |
358 |
$10K |
| 2022 |
636 |
$19K |
| 2023 |
313 |
$9K |
| 2024 |
48 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
611 |
602 |
$30K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,087 |
958 |
$18K |
| D1120 |
Prophylaxis - child |
485 |
478 |
$16K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
245 |
141 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
988 |
971 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
103 |
103 |
$5K |
| D1206 |
Topical application of fluoride varnish |
412 |
406 |
$4K |
| D1110 |
Prophylaxis - adult |
45 |
45 |
$2K |
| D2140 |
|
42 |
25 |
$2K |
| D9951 |
|
28 |
14 |
$840.00 |