STAR CLINIC
NPI: 1790058741
· INDIANAPOLIS, IN 46241
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 02/21/2012
Provider Details
Related Entities
Other providers sharing the same authorized official: GHEBREMICHAEL, ESTHER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
65 |
$2K |
| 2021 |
171 |
$6K |
| 2022 |
317 |
$8K |
| 2023 |
165 |
$4K |
| 2024 |
211 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
232 |
204 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
376 |
350 |
$9K |
| D0274 |
Bitewings - four radiographic images |
122 |
109 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
114 |
96 |
$4K |
| D1206 |
Topical application of fluoride varnish |
67 |
56 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
18 |
13 |
$91.44 |