EASTERN DENTAL OF EATONTOWN, LLC
NPI: 1740493337
· OAKHURST, NJ 07755
· General Practice Dentistry
· NPI assigned 05/08/2007
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | GOLDBERG, JASON (DIRECTOR) |
| NPI Enumeration Date | 05/08/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
430 |
$0.00 |
| 2021 |
348 |
$0.00 |
| 2022 |
139 |
$0.00 |
| 2023 |
210 |
$0.00 |
| 2024 |
31 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
225 |
224 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
51 |
51 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$0.00 |
| D1999 |
|
465 |
415 |
$0.00 |
| D0330 |
Panoramic radiographic image |
58 |
58 |
$0.00 |
| D1110 |
Prophylaxis - adult |
299 |
299 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
33 |
31 |
$0.00 |