WEST COAST SMILES
NPI: 1669801742
· VISTA, CA 92081
· Dentist
· NPI assigned 11/08/2013
$525.00
Total Medicaid Paid
Provider Details
| Authorized Official | PLAMENAC, JOVAN (DENTIST) |
| NPI Enumeration Date | 11/08/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$357.00 |
| 2020 |
14 |
$168.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
12 |
12 |
$357.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
12 |
$168.00 |