BETHESDA DENTAL SPECIALISTS LLC
NPI: 1699543132
· BETHESDA, MD 20814
· Dentist
· NPI assigned 12/14/2023
$113K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: ROUHANIAN, MOHAMMAD
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
3,111 |
$113K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
568 |
568 |
$32K |
| D1120 |
Prophylaxis - child |
601 |
601 |
$29K |
| D1206 |
Topical application of fluoride varnish |
813 |
813 |
$21K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
53 |
32 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
158 |
158 |
$5K |
| D1351 |
Sealant - per tooth |
107 |
25 |
$4K |
| D0272 |
Bitewings - two radiographic images |
246 |
246 |
$4K |
| D1110 |
Prophylaxis - adult |
46 |
46 |
$3K |
| D1330 |
|
338 |
338 |
$2K |
| D0274 |
Bitewings - four radiographic images |
74 |
74 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
70 |
63 |
$1K |
| D0330 |
Panoramic radiographic image |
24 |
24 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$153.66 |