EASTERN DENTAL OF OLD BRIDGE, LLC
NPI: 1770631772
· SOUTH AMBOY, NJ 08879
· General Practice Dentistry
· NPI assigned 01/08/2007
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
596 |
$1K |
| 2021 |
962 |
$0.00 |
| 2022 |
1,354 |
$0.00 |
| 2023 |
942 |
$0.00 |
| 2024 |
375 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
735 |
496 |
$551.00 |
| D0120 |
Periodic oral evaluation - established patient |
481 |
478 |
$378.00 |
| D0220 |
Intraoral - periapical first radiographic image |
687 |
675 |
$286.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
402 |
401 |
$207.00 |
| D1110 |
Prophylaxis - adult |
395 |
391 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
351 |
348 |
$0.00 |
| D0330 |
Panoramic radiographic image |
467 |
466 |
$0.00 |
| D1120 |
Prophylaxis - child |
15 |
15 |
$0.00 |
| D1999 |
|
582 |
507 |
$0.00 |
| D1351 |
Sealant - per tooth |
85 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
17 |
17 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$0.00 |