ALCANTARA RUIZ, JOSE ANTONIO
NPI: 1780342212
· SALEM, OR 97301
· Dental Hygienist
· NPI assigned 12/01/2021
$122.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
610 |
$122.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0191 |
|
157 |
157 |
$64.00 |
| D1206 |
Topical application of fluoride varnish |
87 |
87 |
$57.00 |
| D0602 |
|
95 |
95 |
$1.00 |
| D1351 |
Sealant - per tooth |
56 |
17 |
$0.00 |
| D1330 |
|
156 |
156 |
$0.00 |
| D0603 |
|
59 |
59 |
$0.00 |