JOSE ENRIQUE AREVALO DDS, PLLC
NPI: 1760987168
· SAN ANTONIO, TX 78221
· Dental Clinic/Center
· NPI assigned 03/27/2018
$368K
Total Medicaid Paid
Provider Details
| Authorized Official | AREVALO, JOSE (OWNER) |
| NPI Enumeration Date | 03/27/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
115 |
$1K |
| 2021 |
1,527 |
$59K |
| 2022 |
2,000 |
$122K |
| 2023 |
1,203 |
$119K |
| 2024 |
626 |
$66K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
590 |
552 |
$316K |
| D0140 |
Limited oral evaluation - problem focused |
1,074 |
1,050 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
1,326 |
1,298 |
$15K |
| D0460 |
|
865 |
839 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
85 |
76 |
$6K |
| D0270 |
|
928 |
907 |
$4K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
25 |
25 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
518 |
474 |
$3K |
| D3910 |
|
60 |
58 |
$34.46 |