SOBOL DENTAL CORPORATION
NPI: 1750895132
· SANTA CLARITA, CA 91350
· Dental Clinic/Center
· NPI assigned 11/21/2017
$139K
Total Medicaid Paid
Provider Details
| Authorized Official | SOBOL, HENRY (PRESIDENT) |
| NPI Enumeration Date | 11/21/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
29 |
$1K |
| 2021 |
93 |
$4K |
| 2022 |
499 |
$18K |
| 2023 |
3,052 |
$58K |
| 2024 |
3,652 |
$58K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0350 |
|
4,347 |
1,124 |
$39K |
| D1110 |
Prophylaxis - adult |
246 |
241 |
$22K |
| D4910 |
|
205 |
205 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
189 |
189 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
199 |
196 |
$13K |
| D1206 |
Topical application of fluoride varnish |
574 |
572 |
$10K |
| D1320 |
|
419 |
419 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
128 |
125 |
$6K |
| D4341 |
|
56 |
12 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
782 |
279 |
$3K |
| D0274 |
Bitewings - four radiographic images |
135 |
135 |
$3K |
| D1120 |
Prophylaxis - child |
28 |
28 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
17 |
12 |
$1K |