RESEDA VILLAGE DENTAL STUDIO
NPI: 1639491004
· RESEDA, CA 91335
· Preferred Provider Organization
· NPI assigned 02/25/2010
$639.00
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
58 |
$639.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
17 |
16 |
$195.00 |
| D1206 |
Topical application of fluoride varnish |
15 |
14 |
$168.00 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
12 |
$159.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$117.00 |