SIMONWONGDDSINC
NPI: 1689912131
· GLENDALE, CA 91202
· Dentist
· NPI assigned 01/17/2013
$313K
Total Medicaid Paid
Provider Details
| Authorized Official | WONG, SIMON (PRESIDENT) |
| NPI Enumeration Date | 01/17/2013 |
Related Entities
Other providers sharing the same authorized official: WONG, SIMON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
387 |
$19K |
| 2019 |
1,467 |
$67K |
| 2020 |
859 |
$44K |
| 2021 |
899 |
$40K |
| 2022 |
1,211 |
$49K |
| 2023 |
1,796 |
$64K |
| 2024 |
671 |
$30K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,470 |
1,464 |
$94K |
| D9430 |
|
2,324 |
1,859 |
$74K |
| D0210 |
Intraoral - complete series of radiographic images |
1,119 |
1,113 |
$53K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
366 |
134 |
$43K |
| D1110 |
Prophylaxis - adult |
327 |
327 |
$29K |
| D0220 |
Intraoral - periapical first radiographic image |
559 |
508 |
$7K |
| D1206 |
Topical application of fluoride varnish |
348 |
348 |
$6K |
| D0350 |
|
292 |
153 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
36 |
36 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
384 |
203 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
65 |
65 |
$876.00 |