CUSCATLAN DENTAL CENTER
NPI: 1821407065
· PICO RIVERA, CA 90660
· Dentist
· NPI assigned 08/12/2014
$108K
Total Medicaid Paid
Provider Details
| Authorized Official | CRUZ, MAY (DDS) |
| NPI Enumeration Date | 08/12/2014 |
Related Entities
Other providers sharing the same authorized official: CRUZ, MAY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
571 |
$9K |
| 2019 |
565 |
$11K |
| 2020 |
743 |
$19K |
| 2021 |
833 |
$18K |
| 2022 |
609 |
$20K |
| 2023 |
609 |
$15K |
| 2024 |
572 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
703 |
698 |
$40K |
| D1110 |
Prophylaxis - adult |
181 |
180 |
$16K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,723 |
1,508 |
$16K |
| D0272 |
Bitewings - two radiographic images |
1,211 |
1,202 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
145 |
143 |
$9K |
| D1120 |
Prophylaxis - child |
268 |
268 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
271 |
271 |
$4K |