GUPTA, CHITVAN
NPI: 1881929057
· GLEN COVE, NY 11542
· General Practice Dentistry
· NPI assigned 10/06/2009
$258.54
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
38 |
$258.54 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$137.80 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$75.79 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$44.95 |