NOVA DENTAL EAST LLC
NPI: 1629313077
· WALLINGFORD, CT 06492
· Dentist
· NPI assigned 12/11/2012
$115K
Total Medicaid Paid
Provider Details
| Authorized Official | IJAZ, ASMA (OWNER) |
| NPI Enumeration Date | 12/11/2012 |
Related Entities
Other providers sharing the same authorized official: IJAZ, ASMA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
200 |
$6K |
| 2019 |
403 |
$11K |
| 2020 |
234 |
$6K |
| 2021 |
605 |
$17K |
| 2022 |
558 |
$15K |
| 2023 |
1,010 |
$30K |
| 2024 |
1,053 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,027 |
1,007 |
$25K |
| D1110 |
Prophylaxis - adult |
664 |
651 |
$24K |
| D1208 |
Topical application of fluoride, excluding varnish |
938 |
923 |
$20K |
| D0140 |
Limited oral evaluation - problem focused |
532 |
502 |
$14K |
| D0274 |
Bitewings - four radiographic images |
430 |
424 |
$14K |
| D1120 |
Prophylaxis - child |
152 |
150 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
154 |
142 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
47 |
46 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
119 |
118 |
$2K |