SAFARI DENTAL INC
NPI: 1699005736
· MIDWEST CITY, OK 73110
· General Practice Dentistry
· NPI assigned 01/13/2010
$367K
Total Medicaid Paid
Provider Details
| Authorized Official | MENSER, NIKITA (BUSINESS MANAGER) |
| NPI Enumeration Date | 01/13/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
199 |
$92K |
| 2019 |
219 |
$107K |
| 2020 |
54 |
$63K |
| 2021 |
52 |
$57K |
| 2022 |
28 |
$34K |
| 2023 |
12 |
$12K |
| 2024 |
76 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
323 |
323 |
$355K |
| D9310 |
|
202 |
202 |
$9K |
| D0340 |
|
13 |
13 |
$755.04 |
| D0470 |
|
13 |
13 |
$471.90 |
| D0350 |
|
13 |
13 |
$377.65 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$372.04 |
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$324.42 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$278.05 |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
16 |
$248.49 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18 |
15 |
$141.01 |