ALICIA K. WONG, DMD, MPH, PLLC
NPI: 1689914194
· BELLEVUE, WA 98005
· Pediatric Dentist
· NPI assigned 02/20/2013
$437.65
Total Medicaid Paid
Provider Details
| Authorized Official | WONG, ALICIA (DENTIST/OWNER) |
| NPI Enumeration Date | 02/20/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$437.65 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$268.49 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$169.16 |