BON DENTAL
NPI: 1891281366
· WEST HAVEN, CT 06516
· General Practice Dentistry
· NPI assigned 07/07/2018
$186K
Total Medicaid Paid
Provider Details
| Authorized Official | KU, RYAN (OWNER) |
| NPI Enumeration Date | 07/07/2018 |
Related Entities
Other providers sharing the same authorized official: KU, RYAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
513 |
$19K |
| 2019 |
1,199 |
$44K |
| 2020 |
985 |
$34K |
| 2021 |
719 |
$25K |
| 2022 |
571 |
$20K |
| 2023 |
596 |
$20K |
| 2024 |
980 |
$24K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,615 |
1,558 |
$69K |
| D0120 |
Periodic oral evaluation - established patient |
1,737 |
1,656 |
$53K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,508 |
1,459 |
$40K |
| D0274 |
Bitewings - four radiographic images |
422 |
404 |
$17K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
44 |
26 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
119 |
100 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
101 |
54 |
$1K |
| D1110 |
Prophylaxis - adult |
17 |
13 |
$457.60 |