KTLE DMD, PC
NPI: 1770067001
· ONTARIO, CA 91761
· General Practice Dentistry
· NPI assigned 09/22/2018
Provider Details
| Authorized Official | LE, KY (PRESIDENT) |
| NPI Enumeration Date | 09/22/2018 |
Related Entities
Other providers sharing the same authorized official: LE, KY
| Provider | City | State | Total Paid |
|---|
| KY LE LLC |
AIEA |
HI |
$151K |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
951 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
133 |
133 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
90 |
90 |
$4K |
| D0350 |
|
421 |
106 |
$4K |
| D4341 |
|
55 |
15 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
40 |
15 |
$3K |
| D1110 |
Prophylaxis - adult |
18 |
18 |
$2K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$630.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
138 |
26 |
$558.90 |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$514.00 |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$390.00 |