HANNA, SARAH
NPI: 1811010697
· MONSEY, NY 10952
· Dentist
· NPI assigned 04/09/2007
$257.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
303 |
$257.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
58 |
58 |
$180.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$25.00 |
| D0120 |
Periodic oral evaluation - established patient |
54 |
54 |
$25.00 |
| D0220 |
Intraoral - periapical first radiographic image |
62 |
62 |
$15.00 |
| D0274 |
Bitewings - four radiographic images |
53 |
53 |
$12.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
48 |
48 |
$0.00 |
| D1120 |
Prophylaxis - child |
15 |
15 |
$0.00 |