ELICA HEALTH CENTERS
NPI: 1740660703
· SACRAMENTO, CA 95825
· Case Manager/Care Coordinator
· NPI assigned 06/04/2015
Provider Details
| Authorized Official | BAK, TATYANA (CEO) |
| NPI Enumeration Date | 06/04/2015 |
Related Entities
Other providers sharing the same authorized official: BAK, TATYANA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
24 |
$0.00 |
| 2024 |
983 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1310 |
|
45 |
45 |
$922.71 |
| D1206 |
Topical application of fluoride varnish |
149 |
149 |
$668.56 |
| D1120 |
Prophylaxis - child |
30 |
30 |
$542.26 |
| D0603 |
|
12 |
12 |
$90.50 |
| D0330 |
Panoramic radiographic image |
99 |
99 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
88 |
88 |
$0.00 |
| D4341 |
|
77 |
28 |
$0.00 |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
214 |
214 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
80 |
80 |
$0.00 |
| D1330 |
|
161 |
161 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
22 |
12 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
16 |
12 |
$0.00 |