SANDRA P. LARA DDS . INC
NPI: 1790257848
· SAN JOSE, CA 95128
· Dentist
· NPI assigned 12/28/2018
$1.69M
Total Medicaid Paid
Provider Details
| Authorized Official | LARA, SANDRA (OWNER) |
| NPI Enumeration Date | 12/28/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,903 |
$243K |
| 2021 |
3,073 |
$435K |
| 2022 |
2,984 |
$434K |
| 2023 |
2,343 |
$344K |
| 2024 |
1,786 |
$238K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,526 |
1,486 |
$707K |
| D3320 |
|
1,118 |
1,025 |
$408K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,201 |
4,201 |
$277K |
| D0210 |
Intraoral - complete series of radiographic images |
4,202 |
4,202 |
$201K |
| D3310 |
|
280 |
242 |
$85K |
| D9430 |
|
312 |
310 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
223 |
222 |
$3K |
| D9110 |
|
18 |
17 |
$882.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
209 |
199 |
$846.45 |