EDALAT DENTAL GROUP, APC
NPI: 1730794801
· NORTHRIDGE, CA 91325
· Dental Clinic/Center
· NPI assigned 09/15/2020
$304K
Total Medicaid Paid
Provider Details
| Authorized Official | EDALAT, SAMAN (PRESIDENT) |
| NPI Enumeration Date | 09/15/2020 |
Related Entities
Other providers sharing the same authorized official: EDALAT, SAMAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
653 |
$17K |
| 2021 |
1,849 |
$62K |
| 2022 |
2,617 |
$81K |
| 2023 |
2,604 |
$78K |
| 2024 |
2,217 |
$66K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,882 |
1,878 |
$122K |
| D0210 |
Intraoral - complete series of radiographic images |
1,469 |
1,467 |
$63K |
| D0120 |
Periodic oral evaluation - established patient |
364 |
364 |
$26K |
| D1120 |
Prophylaxis - child |
429 |
429 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,082 |
1,080 |
$18K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,022 |
817 |
$13K |
| D9430 |
|
402 |
377 |
$12K |
| D0330 |
Panoramic radiographic image |
342 |
338 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
598 |
595 |
$7K |
| D1110 |
Prophylaxis - adult |
57 |
57 |
$5K |
| D4910 |
|
45 |
45 |
$4K |
| D1351 |
Sealant - per tooth |
153 |
34 |
$3K |
| D9993 |
|
21 |
20 |
$1K |
| D1310 |
|
22 |
20 |
$736.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$243.00 |
| D0350 |
|
21 |
13 |
$240.00 |
| D0603 |
|
18 |
16 |
$210.00 |