GILBERTO LOPEZ DDS INC
NPI: 1902068018
· FORT SMITH, AR 72901
· Dental Clinic/Center
· NPI assigned 06/30/2008
$180K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
549 |
$14K |
| 2019 |
423 |
$9K |
| 2020 |
638 |
$17K |
| 2021 |
1,144 |
$31K |
| 2022 |
1,394 |
$39K |
| 2023 |
1,300 |
$36K |
| 2024 |
1,219 |
$34K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,736 |
1,663 |
$74K |
| D0120 |
Periodic oral evaluation - established patient |
1,789 |
1,719 |
$43K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,663 |
1,592 |
$30K |
| D0272 |
Bitewings - two radiographic images |
1,275 |
1,236 |
$25K |
| D1120 |
Prophylaxis - child |
190 |
183 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$468.80 |